Provider Demographics
NPI:1780760439
Name:KRAMER, CAROL ANN
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANN
Last Name:KRAMER
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 1:113 25TH AVE S STE 1
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-5329
Mailing Address - Country:US
Mailing Address - Phone:320-258-4494
Mailing Address - Fax:320-258-4496
Practice Address - Street 1:161 19TH ST S
Practice Address - Street 2:SUITE 111
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4579
Practice Address - Country:US
Practice Address - Phone:320-258-4494
Practice Address - Fax:320-258-4496
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2559237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN355M2ACMedicaid
MN355M2ACOtherBLUECROSS/BLUESHIELD
MN4550011Medicaid
MN937G9ACMedicaid
MN050419004Medicaid
MN106937OtherHEALTH PARTNERS
MN106937Medicaid
MN180761Medicaid
MN777765500Medicaid
MN4550011OtherMEDICA