Provider Demographics
NPI:1912007832
Name:PALMER, JEANNE H (MSN)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:H
Last Name:PALMER
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:MRS
Other - First Name:JEANNE
Other - Middle Name:H
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN
Mailing Address - Street 1:105 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-8134
Mailing Address - Country:US
Mailing Address - Phone:601-898-9799
Mailing Address - Fax:
Practice Address - Street 1:1500 E. WOODROW WILSON DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-5116
Practice Address - Country:US
Practice Address - Phone:601-362-4471
Practice Address - Fax:601-364-1305
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR604321364SP0809X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult