Healthcare Provider Details

I. General information

NPI: 1962410712
Provider Name (Legal Business Name): DEBORAH A PALMER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 MONTLIMAR SUITE A-180
MOBILE AL
36609
US

IV. Provider business mailing address

1015 MONTLIMAR SUITE A-180
MOBILE AL
36609
US

V. Phone/Fax

Practice location:
  • Phone: 251-343-4101
  • Fax: 251-343-4789
Mailing address:
  • Phone: 251-343-4101
  • Fax: 251-343-4789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1036513
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: