Provider Demographics
NPI:1609866201
Name:KRAMER, AMY L (CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:KRAMER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-135126-6363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
132974OtherU-CARE
HP53181OtherHEALTH PARTNERS
2365758OtherARAZ GROUP/AMERICAS PPO
185P8KROtherBLUE CROSS BLUE SHIELD
0120945OtherMEDICA HEALTH PLANS
6D053CEOtherBLUE CROSS BLUE SHIELD
1044104OtherPREFERRED ONE
470014700OtherMEDICAL ASSISTANCE (MA)
470014700OtherMEDICAL ASSISTANCE (MA)
Q48889Medicare UPIN