Provider Demographics
NPI:1265202287
Name:KRAMER, WENDY (FNP-C)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:DE LOS SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2162 E WILLIAMS FIELD RD STE 111
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0736
Mailing Address - Country:US
Mailing Address - Phone:480-795-1515
Mailing Address - Fax:480-597-1723
Practice Address - Street 1:2162 E WILLIAMS FIELD RD STE 111
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0736
Practice Address - Country:US
Practice Address - Phone:480-795-1515
Practice Address - Fax:480-597-1723
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ298060363LA2200X, 363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ298060OtherARIZONA STATE BOARD OF NURSING