Provider Demographics
NPI:1487297081
Name:GUTIERREZ, JULIE C (DNP, PMHNP-BC, BSN,)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:C
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, BSN,
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:C
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2021 HENDOLA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4807
Mailing Address - Country:US
Mailing Address - Phone:505-440-3127
Mailing Address - Fax:
Practice Address - Street 1:1501 SAN PEDRO DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5180
Practice Address - Country:US
Practice Address - Phone:505-265-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-70741163W00000X
NM58108363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse