Healthcare Provider Details

I. General information

NPI: 1992221824
Provider Name (Legal Business Name): KELLY MICHELLE STONE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 N FRONTAGE RD W
VAIL CO
81657-4897
US

IV. Provider business mailing address

2109 N FRONTAGE RD W
VAIL CO
81657-4897
US

V. Phone/Fax

Practice location:
  • Phone: 970-476-1621
  • Fax:
Mailing address:
  • Phone: 970-476-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA.0021916
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: