Healthcare Provider Details

I. General information

NPI: 1285625335
Provider Name (Legal Business Name): CAROL ANDREA CRAMER CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93638-8761
US

IV. Provider business mailing address

5118 COLE RD
MARIPOSA CA
95338-9601
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5803
  • Fax:
Mailing address:
  • Phone: 209-966-6325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP5819
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: