Provider Demographics
NPI:1184387987
Name:PALMER, NEDENE EVADNEY (RN)
Entity type:Individual
Prefix:
First Name:NEDENE
Middle Name:EVADNEY
Last Name:PALMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NEDENE
Other - Middle Name:EVADNEY
Other - Last Name:PEART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:14445 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-3109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14445 87TH AVE
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-3109
Practice Address - Country:US
Practice Address - Phone:718-480-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY767799163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse