Healthcare Provider Details

I. General information

NPI: 1508118787
Provider Name (Legal Business Name): TERRIE STONEBRAKER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA THERESE STONEBRAKER RPH

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 HARTSEL DR
COLORADO SPRINGS CO
80920-4165
US

IV. Provider business mailing address

3570 HARTSEL DR
COLORADO SPRINGS CO
80920-4165
US

V. Phone/Fax

Practice location:
  • Phone: 719-590-7515
  • Fax: 719-590-7085
Mailing address:
  • Phone: 719-590-7515
  • Fax: 719-590-7085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number13979
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13979
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: