Provider Demographics
NPI:1811592074
Name:KRAMER, CASEY SCOTT
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:SCOTT
Last Name:KRAMER
Suffix:
Gender:M
Credentials:
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:ROSE
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:951 LAS PALMAS ENTRADA AVE APT 1214
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5617
Mailing Address - Country:US
Mailing Address - Phone:702-686-7173
Mailing Address - Fax:
Practice Address - Street 1:3680 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3180
Practice Address - Country:US
Practice Address - Phone:702-646-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner