Provider Demographics
NPI:1356148225
Name:CRAMER, KYLA ANN
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:ANN
Last Name:CRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 E 45TH ST APT I10
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-4156
Mailing Address - Country:US
Mailing Address - Phone:308-383-5638
Mailing Address - Fax:
Practice Address - Street 1:16821 CENTER PLACE RD
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4104
Practice Address - Country:US
Practice Address - Phone:308-325-1749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE580850923747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider