Healthcare Provider Details

I. General information

NPI: 1629963814
Provider Name (Legal Business Name): PALMER JEREL LAMARTINIERE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 HOUMA BLVD
METAIRIE LA
70006-2996
US

IV. Provider business mailing address

4301 TULANE AVE APT 282
NEW ORLEANS LA
70119-6755
US

V. Phone/Fax

Practice location:
  • Phone: 504-503-4000
  • Fax:
Mailing address:
  • Phone: 225-301-8708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: