Provider Demographics
NPI:1447601844
Name:PALMER, AMINATA
Entity Type:Individual
Prefix:
First Name:AMINATA
Middle Name:
Last Name:PALMER
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 1:2649 CARROLL PL # B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3821
Mailing Address - Country:US
Mailing Address - Phone:907-301-7107
Mailing Address - Fax:907-929-1321
Practice Address - Street 1:2649 CARROLL PL # B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3821
Practice Address - Country:US
Practice Address - Phone:907-301-7107
Practice Address - Fax:907-929-1321
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNUAA13307376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide