MEDICARE: MS. EVELYN B PALMER RN

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
1	163WH0200X	Home Health Registered Nurse	517782	TX

General Provider Information

NPI Number	:	1952488488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EVELYN B PALMER RN

Provider Business Mailing Address
First Line	:	4500 S LANCASTER RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-7167
Country	:	US
Telephone Number	:	214-857-1748
Fax Number	:	271-857-1719

Provider Business Practice Location Address
First Line	:	3020 SONORA TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-5006
Country	:	US
Telephone Number	:	817-244-6083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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