=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386872778
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARRIE ANN KRAMER O.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2009
-----------------------------------------------------
Last Update Date | 09/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12801 KANSAS AVE
-----------------------------------------------------
City | BONNER SPRINGS
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66012-9202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-228-0111
-----------------------------------------------------
Fax | 913-228-0122
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5801 W 152ND PL
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66223-3257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-228-0111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 1857
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------