MEDICARE: JENNAH MARIE PALMER FNP-C

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	363LF0000X	Family Nurse Practitioner	4704315276	MI

General Provider Information

NPI Number	:	1518570563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNAH MARIE PALMER FNP-C

Provider Business Mailing Address
First Line	:	888 E LINCOLN ST
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1784
Country	:	US
Telephone Number	:	906-399-6846
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 W MAPLE RD STE 101
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3118
Country	:	US
Telephone Number	:	248-855-8211
Fax Number	:

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

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	07/17/2025

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