Basic Information
Provider Information
NPI: 1730311242
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KRAMER
FirstName: ALLISON
MiddleName: NAGLE
NamePrefix: MRS.
NameSuffix:  
Credential: CPNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 INDEPENDENCE PT
Address2: SUITE 212
City: GREENVILLE
State: SC
PostalCode: 296154545
CountryCode: US
TelephoneNumber: 8647976044
FaxNumber:  
Practice Location
Address1: 20 MEDICAL RIDGE DR
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296054267
CountryCode: US
TelephoneNumber: 8642207270
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/17/2009
LastUpdateDate: 08/20/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X5004461NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
363LP0200X18167SCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

ID Information
IDTypeStateIssuerDescription
NP231505SC MEDICAID


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