Healthcare Provider Details
I. General information
NPI: 1992064257
Provider Name (Legal Business Name): ALISON A PALMER A.P.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/08/2012
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 TARRYTOWN RD
MANCHESTER NH
03103-2713
US
IV. Provider business mailing address
150 TARRYTOWN RD
MANCHESTER NH
03103-2713
US
V. Phone/Fax
- Phone: 603-622-3162
- Fax: 603-622-8677
- Phone: 603-622-3162
- Fax: 603-622-8677
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 054314-23 |
| License Number State | NH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | 054314-23 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: