Healthcare Provider Details

I. General information

NPI: 1992523864
Provider Name (Legal Business Name): BRITTANY DAWN PALERMO PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 LELIA WING B, OFFICE #4
MAGNOLIA AR
71753
US

IV. Provider business mailing address

1741 LAFAYETTE 27
STAMPS AR
71860-9011
US

V. Phone/Fax

Practice location:
  • Phone: 870-340-2636
  • Fax:
Mailing address:
  • Phone: 870-904-8169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number230574
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: