Provider Demographics
NPI:1447650866
Name:GUTIERREZ SAKAKEENY, VICKI A (PA-C)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:A
Last Name:GUTIERREZ SAKAKEENY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST.
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, FLOOR 2
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2548
Mailing Address - Country:US
Mailing Address - Phone:603-224-4003
Mailing Address - Fax:603-227-7526
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, FLOOR 2
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-4003
Practice Address - Fax:603-227-7526
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPA5131363AM0700X
NH1441363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical