=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700706769
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIKA ELIZABETH GUTIERREZ CARBALLO RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2026
-----------------------------------------------------
Last Update Date | 07/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3822 GREEN ASH CT
-----------------------------------------------------
City | RANDALLSTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21133-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-428-0826
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3822 GREEN ASH CT
-----------------------------------------------------
City | RANDALLSTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21133-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WM0102X
-----------------------------------------------------
Taxonomy Name | Maternal Newborn Registered Nurse
-----------------------------------------------------
License Number | R260834
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------