Provider Demographics
NPI:1982570719
Name:PALMER, MAKENNA R
Entity type:Individual
Prefix:
First Name:MAKENNA
Middle Name:R
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5281 COUNTY ROAD 12
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8313
Mailing Address - Country:US
Mailing Address - Phone:740-533-7033
Mailing Address - Fax:
Practice Address - Street 1:5281 COUNTY ROAD 12
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-8313
Practice Address - Country:US
Practice Address - Phone:740-533-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant