Provider Demographics
NPI:1366625378
Name:CRUSE, CHRISTY L (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:CRUSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 HUTTON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-4564
Mailing Address - Country:US
Mailing Address - Phone:913-721-3133
Mailing Address - Fax:913-721-3150
Practice Address - Street 1:2040 HUTTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-4564
Practice Address - Country:US
Practice Address - Phone:913-721-3133
Practice Address - Fax:913-721-3150
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13478183500000X
MO2003018309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist