Individual
DIANA GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4900 MEDICAL DR APT 1402, SAN ANTONIO, TX 78229-4305
(254) 415-5730
Mailing address
4513 LAUREN MACKENZIE, KILLEEN, TX 76549-5613
(254) 415-5730
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
353425
TX
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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