Provider Demographics
NPI:1700185287
Name:PALMER, KAREN MARIE (RD,LD,CDE)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARIE
Last Name:PALMER
Suffix:
Gender:F
Credentials:RD,LD,CDE
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3435 WEST BROADWAY AVE
Mailing Address - Street 2:NORTH MEMORIAL OUTPATIENT CENTER
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422
Mailing Address - Country:US
Mailing Address - Phone:763-520-5489
Mailing Address - Fax:763-520-1133
Practice Address - Street 1:3435 W BROADWAY AVE
Practice Address - Street 2:NORTH MEMORIAL OUTPATIENT CENTER
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2969
Practice Address - Country:US
Practice Address - Phone:763-520-5489
Practice Address - Fax:763-520-1133
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1843133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered