Provider Demographics
NPI:1669983474
Name:PALMER, ALLISON RENAE (PHARMD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RENAE
Last Name:PALMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10221 MILLSTONE DR APT 1302
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-2551
Mailing Address - Country:US
Mailing Address - Phone:913-302-0571
Mailing Address - Fax:
Practice Address - Street 1:395 N K 7 HWY
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-8913
Practice Address - Country:US
Practice Address - Phone:913-764-7165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017026901183500000X
KS1-103019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist