Basic Information
Provider Information
NPI: 1548267057
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALMER
FirstName: KAREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 325 HANSON ST
Address2:  
City: WINNEMUCCA
State: NV
PostalCode: 894453607
CountryCode: US
TelephoneNumber: 7756252222
FaxNumber: 7756251131
Practice Location
Address1: 325 HANSON ST
Address2:  
City: WINNEMUCCA
State: NV
PostalCode: 894453607
CountryCode: US
TelephoneNumber: 7756252222
FaxNumber: 7756251131
Other Information
ProviderEnumerationDate: 06/30/2005
LastUpdateDate: 04/11/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X0786NVY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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