Provider Demographics
NPI:1134317381
Name:MUNRO-KRAMER, MICHELLE LYNNE (FNP, CNM)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYNNE
Last Name:MUNRO-KRAMER
Suffix:
Gender:F
Credentials:FNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15488 PARK LN
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 TOWNER ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5752
Practice Address - Country:US
Practice Address - Phone:734-544-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239510363LF0000X, 367A00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704239510OtherSTATE OF MICHIGAN NURSE PRACTITIONER LICENSE
MI4704239510OtherSTATE OF MICHIGAN NURSE PRACTITIONER LICENSE
041353081OtherSTATE NURSE LICENSE