Provider Demographics
NPI:1831446608
Name:PALMER, NICOLE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:PALMER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3394 SAXONBURG BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-3169
Mailing Address - Country:US
Mailing Address - Phone:127-670-7074
Mailing Address - Fax:412-767-0708
Practice Address - Street 1:3394 SAXONBURG BLVD STE 600
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-3169
Practice Address - Country:US
Practice Address - Phone:412-767-0707
Practice Address - Fax:412-767-0708
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily