Healthcare Provider Details

I. General information

NPI: 1386767903
Provider Name (Legal Business Name): KAREN HIATT PALMER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N BOULEVARD
TOCCOA GA
30577-1906
US

IV. Provider business mailing address

430 ORLANDO DR
TOCCOA GA
30577-3134
US

V. Phone/Fax

Practice location:
  • Phone: 706-282-4507
  • Fax: 706-282-4511
Mailing address:
  • Phone: 706-282-4507
  • Fax: 706-282-4511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN064939
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: