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NPI Code Detail

MEDICARE: LADY D PALMER

MEDICARE: LADY D PALMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health WorkerMI

General Provider Information

NPI Number : 1285486092
Entity Type Code : Individual
Provider Name (Legal Business Name) : LADY D PALMER
Provider Business Mailing Address
First Line : 1344 W LONG LAKE RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-9271
Country : US
Telephone Number : 231-383-2079
Fax Number :
Provider Business Practice Location Address
First Line : 1344 W LONG LAKE RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49685-9271
Country : US
Telephone Number : 231-383-2079
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2024
Last Update Date : 04/04/2024

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Directions to “ LADY D PALMER ” Practice Location

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