Provider Demographics
NPI:1629896014
Name:GUTIERREZ, DANICA ALITZEL (RN)
Entity type:Individual
Prefix:
First Name:DANICA
Middle Name:ALITZEL
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13705 ASHTON WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3011
Mailing Address - Country:US
Mailing Address - Phone:915-401-6068
Mailing Address - Fax:
Practice Address - Street 1:13705 ASHTON WOODS CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-3011
Practice Address - Country:US
Practice Address - Phone:915-401-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1121802163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse