Individual
MRS. LORI A GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
13060 ISLE DR, BAXTER, MN 56425-8331
(218) 828-2880
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3019
MN
363LW0102X
Women's Health Nurse Practitioner
R128792-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07-01383
MEDICA
—
01
—
1025619
PREFERRED ONE
—
01
—
1107621
AMERICA'S PPO (ARAZ)
—
01
—
140102
UCARE
—
05
—
345497500
—
MN
01
—
44526
SIOUX VALLEY HEALTH PLAN
—
01
—
68G09GU
BCBS MN
MN
01
—
HP31350
HEALTH PARTNERS
—
Enumeration date
01/26/2006
Last updated
03/09/2022
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