Provider Demographics
NPI:1194186007
Name:PALMER, JANNA (CLC)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 E ZIMMERLY CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-2845
Mailing Address - Country:US
Mailing Address - Phone:316-323-7277
Mailing Address - Fax:
Practice Address - Street 1:6608 E ZIMMERLY CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-2845
Practice Address - Country:US
Practice Address - Phone:316-323-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-19
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN