Individual
MRS. AMANDA BIENVENU GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(866) 624-7637
Mailing address
1413 CHOCTAW AVE, METAIRIE, LA 70005-1229
(504) 390-8708
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP08868
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02058555
—
MS
05
—
2430114
—
LA
Enumeration date
07/14/2016
Last updated
11/30/2016
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