Provider Demographics
NPI:1225353840
Name:PALMER, NOEL (FPMHNP-BC)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:FPMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16270 HIGHWAY 21 S
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-7762
Mailing Address - Country:US
Mailing Address - Phone:601-416-8251
Mailing Address - Fax:
Practice Address - Street 1:16270 HIGHWAY 21 S
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:MS
Practice Address - Zip Code:39350-7762
Practice Address - Country:US
Practice Address - Phone:601-416-8251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2015-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR588164363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health