Provider Demographics
NPI:1679980536
Name:KRAMER, MELISSA JEAN (LPN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JEAN
Other - Last Name:DOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2246 LODELL AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-4628
Mailing Address - Country:US
Mailing Address - Phone:937-266-6003
Mailing Address - Fax:
Practice Address - Street 1:2246 LODELL AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-4628
Practice Address - Country:US
Practice Address - Phone:937-266-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 151750-MED-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse