Provider Demographics
NPI:1487129243
Name:CRAMER, PAMELA SUE DOROTHEA (CNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE DOROTHEA
Last Name:CRAMER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:SUE DOROTHEA
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4299
Mailing Address - Country:US
Mailing Address - Phone:419-473-3561
Mailing Address - Fax:
Practice Address - Street 1:1265 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-9055
Practice Address - Country:US
Practice Address - Phone:419-483-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022898363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0318649Medicaid