Doctor Name: | SUSAN R. KRAUTKRAMER |
NPI Number: | 1972560464 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C |
License Number: | 1319 |
Business Practice Address: | 1017 W 7th St Wray, CO - 807581420 |
Business Phone Number: | 9703324895 |
Business Fax Number: | 9703323235 |
Mailing Address: | Po Box 216, WRAY |
State: | CO |
Postal Code: | 807580216 |
Phone Number: | 9703324895 |
Fax Number: | 9703323235 |
NPI Enumeration Date: | 04/27/2006 |
NPI Last Update Date: | 12/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1319 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |