Provider Demographics
NPI:1417930041
Name:GUERRA, CRISTINA L (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:L
Last Name:GUERRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:L
Other - Last Name:GUERRA-HODGES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:314-364-4200
Mailing Address - Fax:850-416-7198
Practice Address - Street 1:7001 ROGERS AVE STE 600
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4073
Practice Address - Country:US
Practice Address - Phone:479-573-3101
Practice Address - Fax:479-573-3102
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4450208600000X
NM2005-0700208600000X
OK27116208600000X
FLME115100208600000X
ARE-16038208600000X
CAA86054208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery