Individual
LIA SLOAN GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(210) 884-3308
Mailing address
496 CHINKAPIN TRL, NEW BRAUNFELS, TX 78132-2979
(210) 884-3308
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
600636
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088294603
—
TX
01
—
88N454
BCBS
TX
Enumeration date
10/31/2005
Last updated
09/11/2020
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