Individual
SUSAN CAMILLE GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
16620 N US HIGHWAY 281 STE 300, SAN ANTONIO, TX 78232-2679
(210) 309-1405
(210) 688-4596
Mailing address
PO BOX 847692, ATT IPM CREDENTIALING, DALLAS, TX 75284-7692
(903) 416-1726
(903) 416-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP125921
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3435414-02
—
TX
Enumeration date
06/13/2014
Last updated
05/16/2019
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