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NPI Code Detail

MEDICARE: KRISTA DEANN PALMER T-LMLP

MEDICARE: KRISTA DEANN PALMER T-LMLP
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
1103T00000XPsychologist2876KS

General Provider Information

NPI Number : 1861977829
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTA DEANN PALMER T-LMLP
Provider Business Mailing Address
First Line : 524 N MAIN ST
Second Line :
City : EL DORADO
State : KS
Zip : 67042-2024
Country : US
Telephone Number : 316-321-6036
Fax Number :
Provider Business Practice Location Address
First Line : 524 N MAIN ST
Second Line :
City : EL DORADO
State : KS
Zip : 67042-2024
Country : US
Telephone Number : 316-321-6036
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2018
Last Update Date : 09/26/2018

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Directions to “ KRISTA DEANN PALMER T-LMLP” Practice Location

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