Provider Demographics
NPI:1780447706
Name:KRAMER, MELISSA DURAN (FNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DURAN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6858 MOONFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3839
Mailing Address - Country:US
Mailing Address - Phone:909-217-4093
Mailing Address - Fax:
Practice Address - Street 1:350 S EUCLID AVE STE C
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-6665
Practice Address - Country:US
Practice Address - Phone:909-591-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026891363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care