Provider Demographics
NPI:1053842047
Name:CRAMER, LISA ANNETTE (APRN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANNETTE
Last Name:CRAMER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANNETTE
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:216 S DALTON DR
Mailing Address - Street 2:
Mailing Address - City:LONE JACK
Mailing Address - State:MO
Mailing Address - Zip Code:64070-9617
Mailing Address - Country:US
Mailing Address - Phone:660-890-4821
Mailing Address - Fax:
Practice Address - Street 1:7100 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-6621
Practice Address - Country:US
Practice Address - Phone:913-599-2440
Practice Address - Fax:913-599-5252
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5377595363LA2200X
MO2017007335363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health