Provider Demographics
NPI:1265245567
Name:PALMER, EMILY ROSE (RN, CDCES)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:PALMER
Suffix:
Gender:F
Credentials:RN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6429 BLAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-8139
Mailing Address - Country:US
Mailing Address - Phone:812-241-5948
Mailing Address - Fax:
Practice Address - Street 1:801 N STATE ST STE 305
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-1270
Practice Address - Country:US
Practice Address - Phone:317-477-6363
Practice Address - Fax:317-477-6366
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28274644A163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator