Provider Demographics
NPI:1114280005
Name:KOURY, CHRISTINA MARIE (PHARM D)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:KOURY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 STATE LINE RD
Mailing Address - Street 2:T-1436
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2723
Mailing Address - Country:US
Mailing Address - Phone:816-444-0019
Mailing Address - Fax:816-410-2981
Practice Address - Street 1:8509 STATE LINE RD
Practice Address - Street 2:T-1436
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2723
Practice Address - Country:US
Practice Address - Phone:816-444-0019
Practice Address - Fax:816-410-2981
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-17
Last Update Date:2012-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011023750183500000X
KS1-15321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist