Provider Demographics
NPI:1609850072
Name:PALMER, ABIGAIL ELIZABETH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ABIGAIL
Middle Name:ELIZABETH
Last Name:PALMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:14417 NE COUNTY ROAD 1471
Mailing Address - Street 2:
Mailing Address - City:WALDO
Mailing Address - State:FL
Mailing Address - Zip Code:32694-4555
Mailing Address - Country:US
Mailing Address - Phone:352-468-2187
Mailing Address - Fax:352-485-2927
Practice Address - Street 1:23320 NORTH STATE ROAD 235
Practice Address - Street 2:ACORN CLINIC
Practice Address - City:BROOKER
Practice Address - State:FL
Practice Address - Zip Code:32622
Practice Address - Country:US
Practice Address - Phone:352-485-1133
Practice Address - Fax:352-485-2927
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA0001778363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S51565Medicare UPIN
FL68306YMedicare ID - Type Unspecified