Gutierrez, Susan M

Gutierrez, Susan M is an individual health care provider with primary practice located at 100 Mercy Way , Joplin MO 64804-4524. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gutierrez, Susan M can be contacted via phone (417) 556-2300.

Contact Information

Primary practice address
100 Mercy Way Joplin MO 64804-4524
Phone: (417) 556-2300
Fax: (417) 556-2906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X 125666 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 125666 Missouri

Profile Details

NPI number 1356366405
LBN Legal business name Gutierrez, Susan M
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Aug 10th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356366405 NPPES
Missouri Other 185426 BCBS
Missouri MEDICAID 200022690A BCBS
Missouri MEDICAID 200253250D BCBS
Missouri Other P01080619 BCBS
Missouri MEDICAID 428980205 BCBS

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