Provider Demographics
NPI:1548868771
Name:DUMMER, KAYTLYN RAE KRAMER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAYTLYN
Middle Name:RAE KRAMER
Last Name:DUMMER
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 1:581 S MILWAUKEE ST
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:WI
Mailing Address - Zip Code:53021-9303
Mailing Address - Country:US
Mailing Address - Phone:920-290-1560
Mailing Address - Fax:
Practice Address - Street 1:2206 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-2241
Practice Address - Country:US
Practice Address - Phone:920-793-8352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20564183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist