Healthcare Provider Details

I. General information

NPI: 1184958738
Provider Name (Legal Business Name): DAWN A PALMER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16212 S BRADLEY DR
OLATHE KS
66062-3931
US

IV. Provider business mailing address

16212 S BRADLEY DR
OLATHE KS
66062-3931
US

V. Phone/Fax

Practice location:
  • Phone: 913-568-9064
  • Fax:
Mailing address:
  • Phone: 913-568-9064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number13-73626-021
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number140622
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number13-73626-021
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number13-73626-021
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: