Healthcare Provider Details

I. General information

NPI: 1245126275
Provider Name (Legal Business Name): KRISTI ZASTROW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 JACKSON ST
SAINT PAUL MN
55101-2595
US

IV. Provider business mailing address

3478 GUNSTON LN
WOODBURY MN
55129-4917
US

V. Phone/Fax

Practice location:
  • Phone: 952-883-6193
  • Fax:
Mailing address:
  • Phone: 814-309-9375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3214
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: