Provider Demographics
NPI:1215401336
Name:PALMER, VANESSA (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21625 GREAT MILLS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-1239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21625 GREAT MILLS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1239
Practice Address - Country:US
Practice Address - Phone:301-904-6901
Practice Address - Fax:877-684-3005
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-12
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR256855363LP0808X, 363LP0808X
KY3015210363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health