Provider Demographics
NPI:1659723518
Name:PALMER, JOHNOLYN CHERTEZ
Entity Type:Individual
Prefix:
First Name:JOHNOLYN
Middle Name:CHERTEZ
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18081 MIDWAY RD APT 3034
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6579
Mailing Address - Country:US
Mailing Address - Phone:214-200-1901
Mailing Address - Fax:
Practice Address - Street 1:18081 MIDWAY RD APT 3034
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6579
Practice Address - Country:US
Practice Address - Phone:214-200-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-04
Last Update Date:2016-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other