Provider Demographics
NPI:1174017883
Name:PALMER, CARLEY JEAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CARLEY
Middle Name:JEAN
Last Name:PALMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 COLLINSON DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1507
Mailing Address - Country:US
Mailing Address - Phone:908-907-6052
Mailing Address - Fax:
Practice Address - Street 1:1910 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2715
Practice Address - Country:US
Practice Address - Phone:732-531-0100
Practice Address - Fax:732-531-0144
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00475000363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical