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Individual

ROSA BELEN GUTIERREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DR, SUITE 258, EDGEWOOD, KY 41017-5401
(859) 341-7246
(859) 341-7867

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
18736
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000033079
ANTHEM BCBS
01
0539304
MEDICAID
OH
01
11308607
CAQH CREDENTIALING
05
64187362
KY
Enumeration date
10/24/2005
Last updated
02/20/2008
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