Provider Demographics
NPI:1093549917
Name:KRAMER, STEFANIE ELLEN (PHARMD)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:ELLEN
Last Name:KRAMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 DUSHORE OVERTON RD
Mailing Address - Street 2:
Mailing Address - City:DUSHORE
Mailing Address - State:PA
Mailing Address - Zip Code:18614-7654
Mailing Address - Country:US
Mailing Address - Phone:570-651-3722
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-4148
Practice Address - Fax:304-598-4073
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0014284183500000X
PARP458551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist