Provider Demographics
NPI:1356307466
Name:KRAMER, JACQUELINE DEE (ARNP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:DEE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:800 OAK STREET
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-0010
Mailing Address - Country:US
Mailing Address - Phone:712-324-5356
Mailing Address - Fax:712-324-6515
Practice Address - Street 1:321 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:IA
Practice Address - Zip Code:51248-7731
Practice Address - Country:US
Practice Address - Phone:712-729-3545
Practice Address - Fax:712-729-5767
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA067675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA21118OtherSIOUX VALLEY HEALTHPLAN
IAS57426Medicare UPIN
IA21118OtherSIOUX VALLEY HEALTHPLAN
IA500027520Medicare ID - Type UnspecifiedRR MEDICARE