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NPI Code Detail

MEDICARE: YERELYN GUTIERREZ FNP-BC

MEDICARE: YERELYN GUTIERREZ FNP-BC
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
1163W00000XRegistered Nurse696254-1NY
2363LF0000XFamily Nurse Practitioner26NJ01222300NJ

General Provider Information

NPI Number : 1932592870
Entity Type Code : Individual
Provider Name (Legal Business Name) : YERELYN GUTIERREZ FNP-BC
Provider Business Mailing Address
First Line : 241 WESTFIELD AVE
Second Line :
City : CLARK
State : NJ
Zip : 07066-1547
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 241 WESTFIELD AVE
Second Line :
City : CLARK
State : NJ
Zip : 07066-1547
Country : US
Telephone Number : 731-381-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2015
Last Update Date : 12/04/2021

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