1710912969 NPI number — DR. LYNETTE D KRAMER MD

Table of content: DR. LYNETTE D KRAMER MD (NPI 1710912969)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710912969 NPI number — DR. LYNETTE D KRAMER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRAMER
Provider First Name:
LYNETTE
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710912969
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 151
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBION
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68620-0151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-395-3213
Provider Business Mailing Address Fax Number:
402-395-3173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1019 SOUTH 8TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBION
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68620-1760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-395-5013
Provider Business Practice Location Address Fax Number:
402-395-2327
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  20177 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: G68226 . This is a "MUTUAL OF OMAHA" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 5954 . This is a "BCBS OF NEBRASKA" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 8328 . This is a "MIDLANDS CHOICE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com