Active NPI
Regina Ann Stanek Etienne, PHARM.D.
- Pharmacist
- Colorado Springs, CO
National Provider Identifier
1114123197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 117038
- Practice address
- 3685 Cherry Plum Dr
Colorado Springs, CO 80920-2827 - Phone
- (719) 205-4512
- NPI assigned
- Jun 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 117038 | MN | Primary |
Addresses
Primary practice location
3685 Cherry Plum Dr
Colorado Springs, CO 80920-2827
Mailing address
3685 Cherry Plum Dr
Colorado Springs, CO 80920-2827
Phone (719) 205-4512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117038 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281484800000",
"number": "1114123197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3685 CHERRY PLUM DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809202827",
"telephone_number": "719-205-4512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3685 CHERRY PLUM DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809202827",
"telephone_number": "719-205-4512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "REGINA",
"middle_name": "ANN STANEK",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-26",
"last_updated": "2010-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.