Provider Demographics
NPI:1538367180
Name:GUTIERREZ, MARIA E (RNC,NP,MSN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:RNC,NP,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HIGHWAY 71 W STE 111
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-4111
Mailing Address - Country:US
Mailing Address - Phone:512-304-0318
Mailing Address - Fax:512-308-9649
Practice Address - Street 1:301 HIGHWAY 71 W STE 111
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4111
Practice Address - Country:US
Practice Address - Phone:512-304-0318
Practice Address - Fax:512-308-9649
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX739954363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health