Provider Demographics
NPI:1053592436
Name:GUTIERREZ, MARIA MARGARITA
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:MARGARITA
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 SIKI CT APT A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-8031
Mailing Address - Country:US
Mailing Address - Phone:702-382-4530
Mailing Address - Fax:
Practice Address - Street 1:2917 SIKI CT APT A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-8031
Practice Address - Country:US
Practice Address - Phone:702-382-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker