Provider Demographics
NPI:1407427388
Name:VETTER-PALMBERG, ANGELIKA
Entity Type:Individual
Prefix:
First Name:ANGELIKA
Middle Name:
Last Name:VETTER-PALMBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 CYPRESS WAY E
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7402
Mailing Address - Country:US
Mailing Address - Phone:561-306-9252
Mailing Address - Fax:
Practice Address - Street 1:1611 CYPRESS WAY E
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-7402
Practice Address - Country:US
Practice Address - Phone:561-306-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011604200305Medicaid