Provider Demographics
NPI:1861892341
Name:IANNUZZI, KRISTA MARIE (AUD)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MARIE
Last Name:IANNUZZI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:KRISTA
Other - Middle Name:MARIE
Other - Last Name:WATERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 COOK ST STE 304
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5339
Practice Address - Country:US
Practice Address - Phone:720-516-9435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000729231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist