Provider Demographics
NPI:1346066693
Name:KRAML, JACQUELINE LEIGH (LPN)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:LEIGH
Last Name:KRAML
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 STONEHENGE AVE NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-2947
Mailing Address - Country:US
Mailing Address - Phone:330-307-4285
Mailing Address - Fax:
Practice Address - Street 1:1805 STONEHENGE AVE NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-2947
Practice Address - Country:US
Practice Address - Phone:330-307-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH189818164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse