Healthcare Provider Details

I. General information

NPI: 1104406727
Provider Name (Legal Business Name): KRISTINA AGUIRRE ATENCIO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTINA NICOLE AGUIRRE

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 E MAPLEWOOD AVE STE 200
GREENWOOD VILLAGE CO
80111-4727
US

IV. Provider business mailing address

PO BOX 840862
DALLAS TX
75284-0862
US

V. Phone/Fax

Practice location:
  • Phone: 303-438-3999
  • Fax: 720-439-9500
Mailing address:
  • Phone: 303-377-7638
  • Fax: 303-780-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number186468
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC-APN.0003039-C-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: