Provider Demographics
NPI:1376901033
Name:CRAMER, ELIZABETH LOREE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LOREE
Last Name:CRAMER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54771 MCKENZIE HWY
Mailing Address - Street 2:
Mailing Address - City:BLUE RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97413-9790
Mailing Address - Country:US
Mailing Address - Phone:541-822-3341
Mailing Address - Fax:541-822-3836
Practice Address - Street 1:54771 MCKENZIE HWY
Practice Address - Street 2:
Practice Address - City:BLUE RIVER
Practice Address - State:OR
Practice Address - Zip Code:97413-9790
Practice Address - Country:US
Practice Address - Phone:418-223-3415
Practice Address - Fax:541-822-3836
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202114836RN163W00000X
KS117605163W00000X
KS53-77161-102363L00000X
KS53-77161363LF0000X
OR202200504NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500804293Medicaid