Healthcare Provider Details

I. General information

NPI: 1306285697
Provider Name (Legal Business Name): LYNNE DEE PALMA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1179 N MCDOWELL BLVD
PETALUMA CA
94954
US

IV. Provider business mailing address

1179 N MCDOWELL BLVD
PETALUMA CA
94954-6559
US

V. Phone/Fax

Practice location:
  • Phone: 707-559-7500
  • Fax: 707-559-7620
Mailing address:
  • Phone: 707-559-7500
  • Fax: 707-559-7620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1290402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: