Healthcare Provider Details

I. General information

NPI: 1447294442
Provider Name (Legal Business Name): LYNNE CATHERINE KRAMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNNE CATHERINE RAYNOR MD

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CMR 402 BOX 1336
APO AE
09180-1336
US

IV. Provider business mailing address

CMR 402 BOX 1336
APO AE
09180-1336
US

V. Phone/Fax

Practice location:
  • Phone: 496371867021
  • Fax: 496371868192
Mailing address:
  • Phone: 496371867021
  • Fax: 496371868192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number46801-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: