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General NPI Number Information
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NPI Number | 1063769446
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Entity Type | Individual
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Provider Name | KIMBERLY MARIE STEWART PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2012
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | 9670 PROMINENT PT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-5000
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Country | US
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Telephone | 719-302-4266
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Fax |
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Provider Business Mailing Address
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Address Line | 1172 MOUNT ESTES DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-3652
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Country | US
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Telephone | 915-373-1920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0019458
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License Number State | CO
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