Provider Demographics
NPI:1740478833
Name:HORTON, CRISTINA SHAREE (MD)
Entity type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:SHAREE
Last Name:HORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:901 E. 104TH ST.
Mailing Address - Street 2:MAILSTOP 400N
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-9712
Mailing Address - Country:US
Mailing Address - Phone:816-502-8756
Mailing Address - Fax:816-923-9670
Practice Address - Street 1:4320 WORNALL RD STE 336
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5963
Practice Address - Country:US
Practice Address - Phone:816-932-6100
Practice Address - Fax:816-932-1786
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301086092207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3461584Medicaid