Healthcare Provider Details

I. General information

NPI: 1336299916
Provider Name (Legal Business Name): LAURA ANN KRAMER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 W AVON RD
AVON CT
06001-3534
US

IV. Provider business mailing address

80 W AVON RD
AVON CT
06001-3534
US

V. Phone/Fax

Practice location:
  • Phone: 860-404-0463
  • Fax: 860-404-0472
Mailing address:
  • Phone: 860-404-0463
  • Fax: 860-404-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number000862
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: