Provider Demographics
NPI:1215541289
Name:KREMER, MIKAYLA MERLENE (ND)
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:MERLENE
Last Name:KREMER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2039 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:KEWASKUM
Mailing Address - State:WI
Mailing Address - Zip Code:53040-9745
Mailing Address - Country:US
Mailing Address - Phone:262-483-2064
Mailing Address - Fax:
Practice Address - Street 1:2039 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:KEWASKUM
Practice Address - State:WI
Practice Address - Zip Code:53040-9745
Practice Address - Country:US
Practice Address - Phone:262-483-2064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath