Provider Demographics
NPI:1932509346
Name:PALMER, FAY
Entity Type:Individual
Prefix:
First Name:FAY
Middle Name:
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:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:MT
Mailing Address - Zip Code:59739-0005
Mailing Address - Country:US
Mailing Address - Phone:406-660-0409
Mailing Address - Fax:
Practice Address - Street 1:23 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:MT
Practice Address - Zip Code:59739
Practice Address - Country:US
Practice Address - Phone:406-660-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7141164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse