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NPI Code Detail

MEDICARE: MR. JERRY EDWARD EDWARD PALMER II

MEDICARE:  MR. JERRY EDWARD EDWARD PALMER II
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
1251E00000XHome Health AgencyMO

General Provider Information

NPI Number : 1356130256
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JERRY EDWARD EDWARD PALMER II
Provider Business Mailing Address
First Line : 7399 TOURNAMENT DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63129-7708
Country : US
Telephone Number : 636-288-4794
Fax Number : 636-288-4794
Provider Business Practice Location Address
First Line : 7399 TOURNAMENT DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63129-7708
Country : US
Telephone Number : 636-288-4794
Fax Number : 636-288-4794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2025
Last Update Date : 02/01/2026

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Directions to “ MR. JERRY EDWARD EDWARD PALMER II ” Practice Location

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