Jackson Luis Gutierrez

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

279143 Issued in AZ

Practice address

18470 E Lark Dr
Queen Creek, AZ 85142-5170

Phone

(615) 282-1052

NPI assigned

Jun 29, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1841977089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18470 E LARK DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425170",
            "telephone_number": "615-282-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18470 E LARK DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425170",
            "telephone_number": "615-282-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JACKSON",
        "middle_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "AZ",
            "license": "279143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Greer, LPC
• Growth Factor Consulting Inc (Beltone Arizona Inc)
• Guardian Anesthesia, PLLC
• William J Gunderman, DC
• Izabella Gutierrez
• Jennifer Anahi Gutierrez, DDS
• Gabrielle Guzman
• Ashley Grace Gyory
• Katherine Hakeman, MSN, FNP
• Misagh Hakimian, RPH

• Nurse's Aide in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Nurse's Aide in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.