Healthcare Provider Details

I. General information

NPI: 1659984979
Provider Name (Legal Business Name): ALEJANDRO J. GUTIERREZ PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 INVERNESS DR STE 400
COLORADO SPRINGS CO
80910-3739
US

IV. Provider business mailing address

1330 INVERNESS DR STE 400
COLORADO SPRINGS CO
80910-3739
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-3406
  • Fax:
Mailing address:
  • Phone: 970-310-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.0197852
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2020044081
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0999052-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: