Provider Demographics
NPI:1609150218
Name:GUTZMAN, KRISTINA RENEE (FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:RENEE
Last Name:GUTZMAN
Suffix:
Gender:
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 1:3400 INDUSTRIAL LN UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1650
Mailing Address - Country:US
Mailing Address - Phone:720-477-6699
Mailing Address - Fax:833-973-4351
Practice Address - Street 1:3400 INDUSTRIAL LN UNIT 1A
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1650
Practice Address - Country:US
Practice Address - Phone:720-477-6699
Practice Address - Fax:833-973-4351
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0106889363LA2100X
CO0996848-NP363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty