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General NPI Number Information
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NPI Number | 1609399120
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Entity Type | Individual
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Provider Name | LISA PALKERT-DAWES PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 1020 VESTAL PKWY E
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City | VESTAL
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State | NY
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Zip | 13850-1748
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Country | US
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Telephone | 607-444-6868
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Fax | 607-444-8618
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Provider Business Mailing Address
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Address Line | 1020 VESTAL PKWY E
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City | VESTAL
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State | NY
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Zip | 13850-1748
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Country | US
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Telephone | 607-444-6868
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Fax | 607-444-8618
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402213
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License Number State | NY
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