Provider Demographics
NPI:1326730615
Name:KRAMER, CHANDLER JACK (A-GNP-C)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:JACK
Last Name:KRAMER
Suffix:
Gender:M
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1628
Mailing Address - Country:US
Mailing Address - Phone:702-362-2273
Mailing Address - Fax:
Practice Address - Street 1:3900 W CHARLESTON BLVD STE 170
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1682
Practice Address - Country:US
Practice Address - Phone:702-362-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV867330363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care