Provider Demographics
NPI:1821412891
Name:PALMER, LISA I (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:I
Last Name:PALMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03781-5315
Mailing Address - Country:US
Mailing Address - Phone:603-675-5812
Mailing Address - Fax:
Practice Address - Street 1:848 STAGE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NH
Practice Address - Zip Code:03781-5315
Practice Address - Country:US
Practice Address - Phone:603-675-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0096722163W00000X
NH066271-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse