Provider Demographics
NPI:1609228535
Name:PALMER, JANICE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4188
Mailing Address - Country:US
Mailing Address - Phone:978-935-8095
Mailing Address - Fax:
Practice Address - Street 1:13 ELLIS ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-4188
Practice Address - Country:US
Practice Address - Phone:978-935-8095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-03
Last Update Date:2016-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN212202163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant