Provider Demographics
NPI:1558183160
Name:GUTIERREZ, CARINA (APRN)
Entity type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:GUTIERREZ
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11860 VISTA DEL SOL DR UNIT 107
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6128
Mailing Address - Country:US
Mailing Address - Phone:915-233-6200
Mailing Address - Fax:
Practice Address - Street 1:11860 VISTA DEL SOL DR UNIT 107
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6128
Practice Address - Country:US
Practice Address - Phone:915-218-4616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-26
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1178709363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health