Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 700814 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 700814 | TX |
NPI | 1013192004 |
---|---|
Provider Name | Kimberlee C Gutierrez |
First Address | Lubbock, TX 79404-2746 |
Second Address | Lubbock, TX 79404-2746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 14/12/2019 |