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General NPI Number Information
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NPI Number | 1942960281
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Entity Type | Organization
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Legal Business Name | PALMER WELLNESS LLC
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Dates
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Enumeration Date | 12/28/2021
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 3085 WOODMAN DR STE 205
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City | KETTERING
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State | OH
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Zip | 45420-1171
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Country | US
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Telephone | 937-471-1999
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Fax | 862-288-4976
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Provider Business Mailing Address
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Address Line | 116 W NATIONAL RD UNIT 123
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City | ENGLEWOOD
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State | OH
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Zip | 45322-5006
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Country | US
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Telephone | 937-471-1999
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Fax | 862-288-4976
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Authorized Official
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Title or Position | OWNER
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Name | SHIRON JONES
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Credential | APRN, ACNP-BC
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Telephone | 937-471-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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