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General NPI Number Information
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NPI Number | 1699256644
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Entity Type | Individual
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Provider Name | CHRISTY PALMER APN
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Gender | Female
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 4173 CRESCENT DR STE A
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City | SAINT LOUIS
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State | MO
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Zip | 63129-1082
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Country | US
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Telephone | 314-858-5604
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Fax |
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Provider Business Mailing Address
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Address Line | 323 EDNA DR
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City | O FALLON
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State | IL
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Zip | 62269-2210
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Country | US
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Telephone | 618-975-1186
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2018024314
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License Number State | MO
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