Provider Demographics
NPI:1417338914
Name:PALMATEER, BETH (NP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:PALMATEER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:KALIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2205 JOLLY RD STE B
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3983
Mailing Address - Country:US
Mailing Address - Phone:517-347-4085
Mailing Address - Fax:517-347-4710
Practice Address - Street 1:1100 E MICHIGAN AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1847
Practice Address - Country:US
Practice Address - Phone:517-789-7122
Practice Address - Fax:517-789-5229
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704244576363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner