Healthcare Provider Details

I. General information

NPI: 1508909060
Provider Name (Legal Business Name): JOAN MARIE PALMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date: 07/17/2007
Reactivation Date: 02/21/2008

III. Provider practice location address

410 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4969
  • Fax: 614-293-6111
Mailing address:
  • Phone: 614-293-4969
  • Fax: 614-293-6111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberHC00148579
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009377RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: