MEDICARE: STEPHANIE CLAIRE KRAMER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	95026064	CA
2	363LA2200X	Adult Health Nurse Practitioner	95026064	CA
3	363LP2300X	Primary Care Nurse Practitioner	95026064	CA

General Provider Information

NPI Number	:	1750061495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE CLAIRE KRAMER NP

Provider Business Mailing Address
First Line	:	175 ORANGE PARK
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92374-5543
Country	:	US
Telephone Number	:	909-557-0701
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 ORANGE PARK
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92374-5543
Country	:	US
Telephone Number	:	909-557-0701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	07/18/2023

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