Healthcare Provider Details

I. General information

NPI: 1740872514
Provider Name (Legal Business Name): ERIN MARIE KRAMER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13861 MANCHESTER RD
BALLWIN MO
63011-4503
US

IV. Provider business mailing address

3345 GALT HOUSE DR
SAINT CHARLES MO
63301-8112
US

V. Phone/Fax

Practice location:
  • Phone: 636-556-0114
  • Fax: 314-270-3694
Mailing address:
  • Phone: 314-306-9133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2020009264
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2011021137
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: