Provider Demographics
NPI:1497986962
Name:PALMER, KARIN M (RD, LD, CDE)
Entity Type:Individual
Prefix:MS
First Name:KARIN
Middle Name:M
Last Name:PALMER
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16939 SAGAMORE RD
Mailing Address - Street 2:
Mailing Address - City:WALTON HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-5127
Mailing Address - Country:US
Mailing Address - Phone:330-467-1124
Mailing Address - Fax:
Practice Address - Street 1:6200 SOM CENTER RD
Practice Address - Street 2:B-22
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2944
Practice Address - Country:US
Practice Address - Phone:216-870-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-02
Last Update Date:2009-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH416133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered