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General NPI Number Information
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NPI Number | 1891263927
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Entity Type | Individual
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Provider Name | JENA CHRISTINE PALMER
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Gender | Female
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 817 E WASHINGTON STREET
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City | MEDINA
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State | OH
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Zip | 44256
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Country | US
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Telephone | 330-536-3746
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Fax |
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Provider Business Mailing Address
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Address Line | 2671 DEER TRL
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City | NILES
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State | OH
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Zip | 44446-4472
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Country | US
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Telephone | 330-978-7390
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.023336
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License Number State | OH
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