Provider Demographics
NPI:1245587112
Name:PALMER, JENNIFER VOLK (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:VOLK
Last Name:PALMER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1132 GOODLETTE RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5451
Practice Address - Country:US
Practice Address - Phone:239-434-8565
Practice Address - Fax:239-434-8569
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9264985363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006435000Medicaid
FL1404209OtherWELLCARE
FLP1005484OtherFREEDOM
FL2752517OtherCIGNA
FL398642OtherAVMED
FLP01716781OtherRR MEDICARE
FLP01807137OtherCLEAR HEALTH ALLIANCE
FL4710387OtherAETNA
FLP979555OtherOPTIMUM
FLY0CK2OtherBCBS
FL398642OtherAVMED