Healthcare Provider Details

I. General information

NPI: 1619947744
Provider Name (Legal Business Name): JANA D KRAMER RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 W 4TH ST
HOLTON KS
66436
US

IV. Provider business mailing address

PO BOX 460
ONAGA KS
66521-0460
US

V. Phone/Fax

Practice location:
  • Phone: 785-364-3205
  • Fax: 785-364-3468
Mailing address:
  • Phone: 785-889-5002
  • Fax: 785-889-7163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1500506
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-00506
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: