Provider Demographics
NPI:1649248238
Name:CRAMER, ELAINE JAUNITA (CRNA)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:JAUNITA
Last Name:CRAMER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8525 LARSEN ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1607
Mailing Address - Country:US
Mailing Address - Phone:918-766-4348
Mailing Address - Fax:
Practice Address - Street 1:8525 LARSEN ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-1607
Practice Address - Country:US
Practice Address - Phone:918-766-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO114061163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100402950AMedicaid
MO430064981OtherRR MEDICARE
MO916811714Medicaid
KS100402950AMedicaid