Provider Demographics
NPI:1467014647
Name:PALMER, HEATHER KAE (RPH)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:KAE
Last Name:PALMER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1594 N 865 W
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:UT
Mailing Address - Zip Code:84015-6694
Mailing Address - Country:US
Mailing Address - Phone:801-776-6292
Mailing Address - Fax:
Practice Address - Street 1:5370 S 1900 W
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-2907
Practice Address - Country:US
Practice Address - Phone:801-825-2788
Practice Address - Fax:801-825-3719
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT152267-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist