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General NPI Number Information
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NPI Number | 1518695261
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Entity Type | Individual
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Provider Name | MARLEY PALMER
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Gender | Female
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 1021 EISENHOWER AVE
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City | GREAT BEND
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State | KS
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Zip | 67530-3213
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Country | US
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Telephone | 620-792-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 911 W 13TH ST
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City | LARNED
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State | KS
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Zip | 67550-1907
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Country | US
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Telephone | 620-804-3377
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-82224-021
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 89757
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License Number State | NE
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