Individual
MARIBEL GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
29 BALA AVE., BRYN MAWR, PA 19010
(610) 668-7741
Mailing address
3043 BOUDINOT ST, PHILADELPHIA, PA 19134-2906
(215) 426-5327
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN263869
PA
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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