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General NPI Number Information
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NPI Number | 1194197400
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Entity Type | Individual
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Provider Name | KRISTIN PALMER
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Gender | Female
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 9006 E EAGLE PLACE
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City | TUCSON
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State | AZ
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Zip | 85749
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Country | US
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Telephone | 520-750-9667
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Fax | 520-750-0050
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Provider Business Mailing Address
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Address Line | 870 W MIRACLE MILE
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City | TUCSON
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State | AZ
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Zip | 85705-3708
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Country | US
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Telephone | 520-750-9667
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Fax | 520-750-0050
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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 | 4660
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License Number State | AZ
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