Provider Demographics
NPI:1942220108
Name:KRAMER, CHRISTINE DAWN (ANP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DAWN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-0070
Mailing Address - Country:US
Mailing Address - Phone:208-762-3768
Mailing Address - Fax:208-762-3718
Practice Address - Street 1:3300 PROVIDENCE DR
Practice Address - Street 2:SUITE 314
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4616
Practice Address - Country:US
Practice Address - Phone:907-561-9540
Practice Address - Fax:907-561-9543
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP41232Medicaid
AKK152968Medicare ID - Type Unspecified
P69232Medicare UPIN