Provider Demographics
NPI:1891384715
Name:PALMER, AMY JANE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JANE
Last Name:PALMER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4960
Mailing Address - Country:US
Mailing Address - Phone:575-706-3226
Mailing Address - Fax:
Practice Address - Street 1:200 CONCORD PLAZA DR. STE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6972
Practice Address - Country:US
Practice Address - Phone:575-706-3226
Practice Address - Fax:210-519-2728
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM60568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily