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General NPI Number Information
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NPI Number | 1932854726
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Entity Type | Individual
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Provider Name | DESHIRE KRAMER
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Gender | Female
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 3868 GRAND CENTRAL PL W
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City | JACKSONVILLE
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State | FL
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Zip | 32246-7638
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Country | US
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Telephone | 904-487-6011
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Fax |
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Provider Business Mailing Address
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Address Line | 3868 GRAND CENTRAL PL W
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City | JACKSONVILLE
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State | FL
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Zip | 32246-7638
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Country | US
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Telephone | 904-487-6011
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F404841
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95029716
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11018191
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License Number State | FL
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