Provider Demographics
NPI:1124859020
Name:KRAMER, KAILA MARIE (RDN)
Entity type:Individual
Prefix:MRS
First Name:KAILA
Middle Name:MARIE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:KAILA
Other - Middle Name:MARIE
Other - Last Name:EBERHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13910 PAPER BIRCH CIR
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8875
Mailing Address - Country:US
Mailing Address - Phone:218-831-4185
Mailing Address - Fax:
Practice Address - Street 1:722 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2912
Practice Address - Country:US
Practice Address - Phone:218-825-2616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1100013133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered