MEDICARE: MS. TERESA PALMER APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1-147880	AL
2	363L00000X	Nurse Practitioner	NN62144	NJ
3	363LA2200X	Adult Health Nurse Practitioner	1147880	AL

General Provider Information

NPI Number	:	1356301543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA PALMER APN

Provider Business Mailing Address
First Line	:	2846 MOODY PKWY STE 300
Second Line	:
City	:	MOODY
State	:	AL
Zip	:	35004-3328
Country	:	US
Telephone Number	:	205-640-1756
Fax Number	:	205-640-1796

Provider Business Practice Location Address
First Line	:	2846 MOODY PKWY STE 300
Second Line	:
City	:	MOODY
State	:	AL
Zip	:	35004-3328
Country	:	US
Telephone Number	:	205-640-1756
Fax Number	:	205-640-1796

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	02/01/2024

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