Healthcare Provider Details

I. General information

NPI: 1942960281
Provider Name (Legal Business Name): PALMER WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2021
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3085 WOODMAN DR STE 205
KETTERING OH
45420-1171
US

IV. Provider business mailing address

116 W NATIONAL RD UNIT 123
ENGLEWOOD OH
45322-5006
US

V. Phone/Fax

Practice location:
  • Phone: 937-709-0957
  • Fax: 937-685-7255
Mailing address:
  • Phone: 937-709-0957
  • Fax: 937-685-7255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHIRON JONES
Title or Position: OWNER/NURSE PRACTITIONER
Credential: MS, APRN, ACNP-BC
Phone: 937-709-0957