Healthcare Provider Details

I. General information

NPI: 1104297332
Provider Name (Legal Business Name): JAMES GUZAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W D ST SUITE 210A
PUEBLO CO
81003-3461
US

IV. Provider business mailing address

43948 HUNSAKER RD
AVONDALE CO
81022-9709
US

V. Phone/Fax

Practice location:
  • Phone: 330-442-3547
  • Fax:
Mailing address:
  • Phone: 330-442-3547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3017014
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0992237-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: