Healthcare Provider Details

I. General information

NPI: 1588528384
Provider Name (Legal Business Name): GABRIELLA PALMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 ASNEBUMSKIT RD
PAXTON MA
01612-1350
US

IV. Provider business mailing address

39 ASNEBUMSKIT RD
PAXTON MA
01612-1350
US

V. Phone/Fax

Practice location:
  • Phone: 508-736-0459
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN10000578
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: