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Individual

JESSICA M GUTIERREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2545 CHICAGO AVE, SUITE 601, MINNEAPOLIS, MN 55404-4522
(612) 863-7770
(612) 863-7772
Mailing address
2545 CHICAGO AVE, SUITE 601, MINNEAPOLIS, MN 55404-4522
(612) 863-7770
(612) 863-7772

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
49995
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
IA
05
ENROLLED
MN
Enumeration date
04/01/2009
Last updated
09/20/2012
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