Provider Demographics
NPI:1326753682
Name:KRAMER, KRISTINE K (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:K
Last Name:KRAMER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:KRISTINE
Other - Middle Name:K
Other - Last Name:DEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22056 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-7362
Mailing Address - Country:US
Mailing Address - Phone:660-853-1553
Mailing Address - Fax:
Practice Address - Street 1:114 E SOUTH HILLS DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-2659
Practice Address - Country:US
Practice Address - Phone:660-562-2525
Practice Address - Fax:660-562-4301
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023001832363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health