Provider Demographics
NPI:1366882169
Name:CARRILLO-GUTIERREZ, CRISTINA IVONNE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:IVONNE
Last Name:CARRILLO-GUTIERREZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 HIGHWAY 6 N STE E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1923
Mailing Address - Country:US
Mailing Address - Phone:281-201-0657
Mailing Address - Fax:
Practice Address - Street 1:8100 HIGHWAY 6 N STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1923
Practice Address - Country:US
Practice Address - Phone:281-201-0657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX728290363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily