Healthcare Provider Details

I. General information

NPI: 1679120588
Provider Name (Legal Business Name): BONNIE CRAMER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 HOSPITAL RD STE 2300
INDIANA PA
15701-3699
US

IV. Provider business mailing address

640 KOLTER DR
INDIANA PA
15701-3570
US

V. Phone/Fax

Practice location:
  • Phone: 888-452-4762
  • Fax: 724-463-1541
Mailing address:
  • Phone: 724-357-7333
  • Fax: 724-357-7279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP020737
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: