=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679318653
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HARLEY NICOLE PALMER FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2024
-----------------------------------------------------
Last Update Date | 09/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 106 W MEDICAL PARK DR STE A
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27292-6854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-248-4413
-----------------------------------------------------
Fax | 336-248-6260
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 60447
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28260-0447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-248-4413
-----------------------------------------------------
Fax | 336-248-6260
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 5022411
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 345674
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------