Healthcare Provider Details

I. General information

NPI: 1972429959
Provider Name (Legal Business Name): ANNA PALMER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WEST AVE S
LA CROSSE WI
54601-4783
US

IV. Provider business mailing address

1612 HYDE AVE
LA CROSSE WI
54601-6535
US

V. Phone/Fax

Practice location:
  • Phone: 608-397-4641
  • Fax:
Mailing address:
  • Phone: 608-397-4641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18640-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: