Provider Demographics
NPI:1093578817
Name:PALMER-MANIRE, ANGI (APRN, DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:ANGI
Middle Name:
Last Name:PALMER-MANIRE
Suffix:
Gender:F
Credentials:APRN, DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12704 N 131ST EAST AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-4164
Mailing Address - Country:US
Mailing Address - Phone:405-334-1012
Mailing Address - Fax:
Practice Address - Street 1:700 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:OK
Practice Address - Zip Code:74010-2302
Practice Address - Country:US
Practice Address - Phone:539-204-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK216238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine