Provider Demographics
NPI:1043661002
Name:CRAMER, KYRIE
Entity Type:Individual
Prefix:
First Name:KYRIE
Middle Name:
Last Name:CRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 HELLE BLVD APT 212
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:MI
Mailing Address - Zip Code:48131-9408
Mailing Address - Country:US
Mailing Address - Phone:734-693-9973
Mailing Address - Fax:
Practice Address - Street 1:142 HELLE BLVD APT 212
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:MI
Practice Address - Zip Code:48131-9408
Practice Address - Country:US
Practice Address - Phone:734-693-9973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2021-06-25
Deactivation Date:2021-06-03
Deactivation Code:
Reactivation Date:2021-06-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other