Provider Demographics
NPI:1700025525
Name:CRAMER, ELLEN JEAN (CNM , NP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:JEAN
Last Name:CRAMER
Suffix:
Gender:F
Credentials:CNM , NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1769 ELLIS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-9654
Mailing Address - Country:US
Mailing Address - Phone:607-592-2460
Mailing Address - Fax:341-300-2087
Practice Address - Street 1:1769 ELLIS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-9654
Practice Address - Country:US
Practice Address - Phone:607-216-8457
Practice Address - Fax:341-300-2087
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420920363L00000X
NY000373367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner