Provider Demographics
NPI:1659430866
Name:PALMER, NANCY G (RNFA, FNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:G
Last Name:PALMER
Suffix:
Gender:F
Credentials:RNFA, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:415-600-0528
Mailing Address - Fax:415-369-1373
Practice Address - Street 1:1100 VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6978
Practice Address - Country:US
Practice Address - Phone:415-600-0528
Practice Address - Fax:415-369-1373
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA468567163WR0006X
CA11575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA468567OtherRN LICENSE#
CA11575OtherNP CERTIFICATE #
CA1798633Medicaid
CA1798633Medicaid
CA468567OtherRN LICENSE#