Provider Demographics
NPI:1609378223
Name:PALMER, KRISTEN PAIGE (LVN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:PAIGE
Last Name:PALMER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-5830
Mailing Address - Country:US
Mailing Address - Phone:903-303-4362
Mailing Address - Fax:
Practice Address - Street 1:1226 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-5830
Practice Address - Country:US
Practice Address - Phone:903-303-4362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX304240164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse