Provider Demographics
NPI:1043633167
Name:CRAMER, MARY SUZANNE (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:SUZANNE
Last Name:CRAMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAPTIST WAKE FOREST MEDICAL CTR
Mailing Address - Street 2:MEDICAL CENTER BLVD
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-1089
Mailing Address - Country:US
Mailing Address - Phone:336-716-1896
Mailing Address - Fax:
Practice Address - Street 1:BAPTIST WAKE FOREST MEDICAL CTR
Practice Address - Street 2:MEDICAL CENTER BLVD
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-1089
Practice Address - Country:US
Practice Address - Phone:336-716-1896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFORS-B7DLQ4363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics