Healthcare Provider Details

I. General information

NPI: 1336662154
Provider Name (Legal Business Name): JULIE M PALMER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 WASHINGTON PIKE STE 303
BRIDGEVILLE PA
15017-2886
US

IV. Provider business mailing address

PO BOX 6230
WHEELING WV
26003-0722
US

V. Phone/Fax

Practice location:
  • Phone: 610-892-3800
  • Fax: 484-468-1412
Mailing address:
  • Phone: 304-242-7106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP.102551
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP017683
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: