MEDICARE: MARY KATHERINE KRAMER APRN

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	363LW0102X	Women's Health Nurse Practitioner	4051815	KY

General Provider Information

NPI Number	:	1790643203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY KATHERINE KRAMER APRN

Provider Business Mailing Address
First Line	:	3015 WILSON AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40211-1969
Country	:	US
Telephone Number	:	502-774-4401
Fax Number	:

Provider Business Practice Location Address
First Line	:	517 KLOTTER AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45214-2082
Country	:	US
Telephone Number	:	502-774-4401
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/16/2026

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