Provider Demographics
NPI:1518591528
Name:PALMER, WILLIAM (RN)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 MURE ST
Mailing Address - Street 2:
Mailing Address - City:BIG SANDY
Mailing Address - State:TX
Mailing Address - Zip Code:75755-2548
Mailing Address - Country:US
Mailing Address - Phone:903-497-7304
Mailing Address - Fax:
Practice Address - Street 1:113 MURE ST
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:TX
Practice Address - Zip Code:75755-2548
Practice Address - Country:US
Practice Address - Phone:903-497-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX836326163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse