Healthcare Provider Details

I. General information

NPI: 1548546948
Provider Name (Legal Business Name): LAUREN CARYL KRAMER PHD, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2011
Last Update Date: 10/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 RECREATION BLDG
UNIVERSITY PARK PA
16802-5700
US

IV. Provider business mailing address

137 BEAGLE RUN CT
STATE COLLEGE PA
16801-2494
US

V. Phone/Fax

Practice location:
  • Phone: 814-863-1758
  • Fax:
Mailing address:
  • Phone: 814-404-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT003577
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: