Provider Demographics
NPI:1407165764
Name:SUMSTINE, TERRA MARIE (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:TERRA
Middle Name:MARIE
Last Name:SUMSTINE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4890 POLEPLANT DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5251
Mailing Address - Country:US
Mailing Address - Phone:719-599-5751
Mailing Address - Fax:
Practice Address - Street 1:4890 POLEPLANT DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5251
Practice Address - Country:US
Practice Address - Phone:719-599-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula