Healthcare Provider Details

I. General information

NPI: 1881389328
Provider Name (Legal Business Name): CARRIE KRAMER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 06/29/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 TWIN HILLS DR
SYRACUSE NY
13207-1516
US

IV. Provider business mailing address

207 TWIN HILLS DR
SYRACUSE NY
13207-1516
US

V. Phone/Fax

Practice location:
  • Phone: 706-993-6848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number685899
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number405031
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: