Provider Demographics
NPI:1437573524
Name:PALMER, ASHLEY (RN MSN, MBA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RN MSN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NW 73RD ST
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-1601
Mailing Address - Country:US
Mailing Address - Phone:816-509-8825
Mailing Address - Fax:
Practice Address - Street 1:200 NW 73RD ST
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-1601
Practice Address - Country:US
Practice Address - Phone:816-509-8825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009003945163W00000X
KS14118585081163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse