Provider Demographics
NPI:1316178148
Name:KRAMER, JOHN MARTIN (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MARTIN
Last Name:KRAMER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10311 BARRANDS LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8026
Mailing Address - Country:US
Mailing Address - Phone:704-763-0940
Mailing Address - Fax:
Practice Address - Street 1:10311 BARRANDS LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-8026
Practice Address - Country:US
Practice Address - Phone:704-763-0940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208334367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC084190OtherAANA