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General NPI Number Information
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NPI Number | 1184672479
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Entity Type | Individual
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Provider Name | MICHELE KREISBERG PALMER PT
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 1101 4TH ST STE 313
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City | SIOUX CITY
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State | IA
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Zip | 51101-1952
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Country | US
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Telephone | 720-226-1448
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Fax | 712-560-8247
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Provider Business Mailing Address
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Address Line | 2213 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5305
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Country | US
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Telephone | 515-237-3974
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Fax | 515-883-2692
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 004466
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 7232
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License Number State | CO
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