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NPI Code Detail

MEDICARE: MS. ANNE C GUTIERREZ MS, ATC, CSCS

MEDICARE: MS. ANNE C GUTIERREZ MS, ATC, CSCS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer0126003868VA

General Provider Information

NPI Number : 1043272560
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANNE C GUTIERREZ MS, ATC, CSCS
Provider Business Mailing Address
First Line : 12433 MAYS QUARTER RD
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22192-5478
Country : US
Telephone Number : 806-549-8467
Fax Number :
Provider Business Practice Location Address
First Line : 2189 ELROD AVE
Second Line :
City : QUANTICO
State : VA
Zip : 22134-5113
Country : US
Telephone Number : 703-432-6536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 03/21/2025

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