Healthcare Provider Details

I. General information

NPI: 1104000751
Provider Name (Legal Business Name): SUSAN FRANCES PALMER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 TONGASS DR
SITKA AK
99835-9416
US

IV. Provider business mailing address

PO BOX 528
CRAIG AK
99921-0528
US

V. Phone/Fax

Practice location:
  • Phone: 907-755-4800
  • Fax: 907-755-4806
Mailing address:
  • Phone: 907-826-2680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number8301
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: