Healthcare Provider Details

I. General information

NPI: 1437573524
Provider Name (Legal Business Name): ASHLEY PALMER RN MSN, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NW 73RD ST
GLADSTONE MO
64118-1601
US

IV. Provider business mailing address

200 NW 73RD ST
GLADSTONE MO
64118-1601
US

V. Phone/Fax

Practice location:
  • Phone: 816-509-8825
  • Fax:
Mailing address:
  • Phone: 816-509-8825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2009003945
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14118585081
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: