Provider Demographics
NPI:1427665595
Name:GUTIERREZ, ELIZABETH TREVINO (FNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TREVINO
Last Name:GUTIERREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 ESTANCIA PKWY
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2630
Mailing Address - Country:US
Mailing Address - Phone:956-203-9114
Mailing Address - Fax:
Practice Address - Street 1:1704 SCOBEY AVE
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2940
Practice Address - Country:US
Practice Address - Phone:956-461-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily