Healthcare Provider Details

I. General information

NPI: 1891095121
Provider Name (Legal Business Name): KRISTINA M BUSZTA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA M LACOSSE CRNA

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE
AURORA CO
80045-2545
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0990665-CRNA
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704248205
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: