Provider Demographics
NPI:1457688335
Name:KRAMER, ANN SIMONICH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:SIMONICH
Last Name:KRAMER
Suffix:
Gender:F
Credentials:DPT
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 764
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-0764
Mailing Address - Country:US
Mailing Address - Phone:208-819-3142
Mailing Address - Fax:
Practice Address - Street 1:655 BRIGGS ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-5022
Practice Address - Country:US
Practice Address - Phone:303-900-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012604225100000X, 225100000X, 225100000X
WAPT 60307952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010160514OtherREGENCE BLUESHIELD
IDT9333OtherBLUE CROSS
ID000010160514OtherREGENCE BLUESHIELD