Healthcare Provider Details

I. General information

NPI: 1316105273
Provider Name (Legal Business Name): GAIL HARRIET KRAMER RNNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 05/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E COTATI AVE STUDENT HEALTH CENTER
ROHNERT PARK CA
94928
US

IV. Provider business mailing address

1801 E COTATI AVE STUDENT HEALTH CENTER SSU
ROHNERT PARK CA
94928
US

V. Phone/Fax

Practice location:
  • Phone: 707-664-2921
  • Fax: 707-664-2925
Mailing address:
  • Phone: 707-664-2921
  • Fax: 707-664-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN172007
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: