Provider Demographics
NPI:1801905047
Name:KRAMER, SHELLEY ANN (ARNP)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:ANN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:ANN
Other - Last Name:THEILKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2213 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-5305
Mailing Address - Country:US
Mailing Address - Phone:515-237-3974
Mailing Address - Fax:515-883-2692
Practice Address - Street 1:2602 NW PARKRIDGE DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9181
Practice Address - Country:US
Practice Address - Phone:515-279-1959
Practice Address - Fax:515-289-0888
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IALO80456363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAQ63567Medicare UPIN