Healthcare Provider Details

I. General information

NPI: 1891156436
Provider Name (Legal Business Name): KRISTIN SPEER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN BRASCHLER PHARM.D.

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 MOUNT CUTLER CT
COLORADO SPRINGS CO
80924
US

IV. Provider business mailing address

5215 MOUNT CUTLER CT
COLORADO SPRINGS CO
80924
US

V. Phone/Fax

Practice location:
  • Phone: 303-956-6896
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0019486
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPHA.0019486
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: