Provider Demographics
NPI:1770834871
Name:KRAMER ELROD, TARA M (CDM)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:M
Last Name:KRAMER ELROD
Suffix:
Gender:F
Credentials:CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 W PARKS HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-6939
Mailing Address - Country:US
Mailing Address - Phone:907-357-7781
Mailing Address - Fax:907-357-7786
Practice Address - Street 1:1301 W PARKS HWY STE 101
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6939
Practice Address - Country:US
Practice Address - Phone:907-357-7781
Practice Address - Fax:907-357-7786
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK72176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife