Provider Demographics
NPI:1689079154
Name:KRAMER, RACHAEL (RN)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13875 EVERGREEN ST NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-2715
Mailing Address - Country:US
Mailing Address - Phone:763-923-8112
Mailing Address - Fax:763-786-9440
Practice Address - Street 1:13875 EVERGREEN ST NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-2715
Practice Address - Country:US
Practice Address - Phone:763-923-8112
Practice Address - Fax:763-786-9440
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR197281-0163WC0400X, 163WH0200X, 174H00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No174H00000XOther Service ProvidersHealth Educator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program