Provider Demographics
NPI:1942960281
Name:PALMER WELLNESS LLC
Entity Type:Organization
Organization Name:PALMER WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRON
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, ACNP-BC
Authorized Official - Phone:937-471-1999
Mailing Address - Street 1:116 W NATIONAL RD UNIT 123
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-5006
Mailing Address - Country:US
Mailing Address - Phone:937-471-1999
Mailing Address - Fax:862-288-4976
Practice Address - Street 1:3085 WOODMAN DR STE 205
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45420-1171
Practice Address - Country:US
Practice Address - Phone:937-471-1999
Practice Address - Fax:862-288-4976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty