Healthcare Provider Details

I. General information

NPI: 1164670766
Provider Name (Legal Business Name): JULIA ANN PALMER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 MORGAN ST
SPRINGFIELD OH
45503-4521
US

IV. Provider business mailing address

1840 MORGAN ST
SPRINGFIELD OH
45503-4521
US

V. Phone/Fax

Practice location:
  • Phone: 937-323-9249
  • Fax: 937-323-9249
Mailing address:
  • Phone: 937-323-9249
  • Fax: 937-323-9249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN240691
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: