Healthcare Provider Details

I. General information

NPI: 1235005869
Provider Name (Legal Business Name): SHONTIA PALMER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1829 REISTERSTOWN RD STE 350
PIKESVILLE MD
21208-7126
US

IV. Provider business mailing address

1829 REISTERSTOWN RD STE 350
PIKESVILLE MD
21208-7126
US

V. Phone/Fax

Practice location:
  • Phone: 443-226-1676
  • Fax: 844-965-9440
Mailing address:
  • Phone: 443-226-1676
  • Fax: 844-965-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR199326
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: