Provider Demographics
NPI:1750196127
Name:PALMER, QUANESHA (APRN)
Entity type:Individual
Prefix:
First Name:QUANESHA
Middle Name:
Last Name:PALMER
Suffix:
Gender:
Credentials:APRN
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 127
Mailing Address - Street 2:
Mailing Address - City:BARTON
Mailing Address - State:AR
Mailing Address - Zip Code:72312-0127
Mailing Address - Country:US
Mailing Address - Phone:870-714-9838
Mailing Address - Fax:
Practice Address - Street 1:1325 LIBERTY DR
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:AR
Practice Address - Zip Code:72042-3430
Practice Address - Country:US
Practice Address - Phone:870-946-3569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR232042363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty