Provider Demographics
NPI:1174398515
Name:HALF MOON HEALTH AND WELLNESS, LTD.
Entity type:Organization
Organization Name:HALF MOON HEALTH AND WELLNESS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:805-400-7747
Mailing Address - Street 1:3400 INDUSTRIAL LN UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1650
Mailing Address - Country:US
Mailing Address - Phone:720-477-6699
Mailing Address - Fax:
Practice Address - Street 1:3400 INDUSTRIAL LN UNIT 1A
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1650
Practice Address - Country:US
Practice Address - Phone:720-912-4098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty