MEDICARE: MRS. KRISTIN SPEER PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PHA.0019486	CO
2	1835P1200X	Pharmacotherapy Pharmacist	PHA.0019486	CO

General Provider Information

NPI Number	:	1891156436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN SPEER PHARM.D.

Provider Business Mailing Address
First Line	:	5215 MOUNT CUTLER CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80924
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 MOUNT CUTLER CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80924
Country	:	US
Telephone Number	:	303-956-6896
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2016
Last Update Date	:	03/10/2016

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