Provider Demographics
NPI:1376158006
Name:CRAMER, CRYSTAL V
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:V
Last Name:CRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:V
Other - Last Name:CRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SHEPHERD
Mailing Address - Street 1:617 CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2916
Mailing Address - Country:US
Mailing Address - Phone:937-489-7740
Mailing Address - Fax:
Practice Address - Street 1:617 CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-2916
Practice Address - Country:US
Practice Address - Phone:937-489-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant