Provider Demographics
NPI:1780663534
Name:KRAMMER, ROBERT OTTO (RN)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:OTTO
Last Name:KRAMMER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 WINDSOR CT SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2150
Mailing Address - Country:US
Mailing Address - Phone:505-892-3525
Mailing Address - Fax:
Practice Address - Street 1:500 SHELLY RD.
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87151-0001
Practice Address - Country:US
Practice Address - Phone:505-839-8837
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR24212163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult