Provider Demographics
NPI:1922581073
Name:PALMER, PAIGE N
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:N
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 1:2425 BRADSHAW WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-8756
Mailing Address - Country:US
Mailing Address - Phone:620-308-6123
Mailing Address - Fax:620-308-6264
Practice Address - Street 1:2425 BRADSHAW WAY
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-8756
Practice Address - Country:US
Practice Address - Phone:620-308-6123
Practice Address - Fax:620-308-6264
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014024763163W00000X
MO2018036933363LF0000X
KS78477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse