=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265202287
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WENDY KRAMER FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/02/2024
-----------------------------------------------------
Last Update Date | 09/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2162 E WILLIAMS FIELD RD STE 111
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85295-0736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-795-1515
-----------------------------------------------------
Fax | 480-597-1723
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2162 E WILLIAMS FIELD RD STE 111
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85295-0736
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-795-1515
-----------------------------------------------------
Fax | 480-597-1723
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 298060
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Nurse Practitioner
-----------------------------------------------------
License Number | 298060
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------