Provider Demographics
NPI:1689158669
Name:KREMER, SHEENA LEE (ARNP)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:LEE
Last Name:KREMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:IA
Mailing Address - Zip Code:52175-1022
Mailing Address - Country:US
Mailing Address - Phone:563-422-3811
Mailing Address - Fax:
Practice Address - Street 1:501 CLARK ST
Practice Address - Street 2:
Practice Address - City:DYSART
Practice Address - State:IA
Practice Address - Zip Code:52224-9524
Practice Address - Country:US
Practice Address - Phone:319-476-4000
Practice Address - Fax:319-476-4127
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA129197363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner