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General NPI Number Information
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NPI Number | 1700940400
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Entity Type | Individual
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Provider Name | MARYJO KRAMER LPN
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 621 N 4TH ST SUITE 300
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City | JEANNETTE
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State | PA
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Zip | 15644-1750
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Country | US
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Telephone | 724-523-6488
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Fax | 724-523-6680
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Provider Business Mailing Address
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Address Line | 621 N 4TH ST SUITE 300
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City | JEANNETTE
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State | PA
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Zip | 15644-1750
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Country | US
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Telephone | 724-523-6488
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Fax | 724-523-6680
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN072007L
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License Number State | PA
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