Individual
GASTON ALBA GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4201 MONTANO RD NW, ALBUQUERQUE, NM 87120-5743
(505) 866-3892
Mailing address
85 WEST HIGHWAY 22, SANTO DOMINGO, NM 87052
(505) 464-3060
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
01771
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24755761
—
NM
Enumeration date
12/14/2006
Last updated
03/07/2023
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