Provider Demographics
NPI:1588034458
Name:PALMER, DAWN L (LPN)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:L
Last Name:PALMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:D
Other - Middle Name:LESLIE
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:2474 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-6419
Mailing Address - Country:US
Mailing Address - Phone:724-541-3702
Mailing Address - Fax:
Practice Address - Street 1:2474 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-6419
Practice Address - Country:US
Practice Address - Phone:724-541-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-04
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN299871164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse