Healthcare Provider Details

I. General information

NPI: 1922342013
Provider Name (Legal Business Name): ANA MARGARITA GUTIERREZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 W 24TH ST
YUMA AZ
85364-8878
US

IV. Provider business mailing address

5929 BALCONES DR STE 200
AUSTIN TX
78731-4280
US

V. Phone/Fax

Practice location:
  • Phone: 928-344-2300
  • Fax: 877-647-0202
Mailing address:
  • Phone: 512-689-4703
  • Fax: 877-647-0202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN095727
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP4776
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: