Healthcare Provider Details

I. General information

NPI: 1528972544
Provider Name (Legal Business Name): VIOLA GUTIERREZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIOLA KEELING RN

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 OAK GROVE RD
POPLAR BLUFF MO
63901-1573
US

IV. Provider business mailing address

513 W MARR ST
POCAHONTAS AR
72455-3449
US

V. Phone/Fax

Practice location:
  • Phone: 573-776-2000
  • Fax:
Mailing address:
  • Phone: 870-378-4506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR106471
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: