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General NPI Number Information
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NPI Number | 1285774240
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Entity Type | Individual
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Provider Name | MARK A PALMER CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 1246 SUNSET HILL RD
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City | WILLISTON
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State | VT
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Zip | 05495-9648
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Country | US
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Telephone | 518-524-4811
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Fax | 802-878-6787
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Provider Business Mailing Address
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Address Line | 1246 SUNSET HILL RD
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City | WILLISTON
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State | VT
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Zip | 05495-9648
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Country | US
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Telephone | 518-524-4811
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Fax | 802-878-6787
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 101-0018823
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 393924-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN281492
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 059130-23
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License Number State | NH
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