Healthcare Provider Details

I. General information

NPI: 1376765651
Provider Name (Legal Business Name): MRS. ROSE MARIE PALMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416A S. 10TH ST.
IRONTON OH
45638-8206
US

IV. Provider business mailing address

1054 CO. RD. 26
IRONTON OH
45638-8206
US

V. Phone/Fax

Practice location:
  • Phone: 740-532-8016
  • Fax:
Mailing address:
  • Phone: 740-532-1513
  • Fax: 174-053-2151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: