Provider Demographics
NPI:1558019026
Name:KRAEMER, PAM
Entity Type:Individual
Prefix:
First Name:PAM
Middle Name:
Last Name:KRAEMER
Suffix:
Gender:F
Credentials:
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 239
Mailing Address - Street 2:
Mailing Address - City:LIDGERWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58053-0239
Mailing Address - Country:US
Mailing Address - Phone:701-640-5492
Mailing Address - Fax:
Practice Address - Street 1:8535 157TH AVE SE
Practice Address - Street 2:
Practice Address - City:LIDGERWOOD
Practice Address - State:ND
Practice Address - Zip Code:58053-9611
Practice Address - Country:US
Practice Address - Phone:701-538-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider