Provider Demographics
NPI:1780303610
Name:KRAMER, KATHRYN CAROLINE (CEP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CAROLINE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:CEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5155 S DURANGO DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0174
Mailing Address - Country:US
Mailing Address - Phone:702-869-4401
Mailing Address - Fax:702-869-9904
Practice Address - Street 1:7375 PRAIRIE FALCON RD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0810
Practice Address - Country:US
Practice Address - Phone:702-869-4401
Practice Address - Fax:702-869-9904
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1064812224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist