Basic Information
| Provider Information | |||||||||
| NPI: | 1942867049 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PALMER MEDICAL SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 381075 | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381831075 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018210338 | ||||||||
| FaxNumber: | 9015078298 | ||||||||
| Practice Location | |||||||||
| Address1: | 984 ROCKY POINT RD | ||||||||
| Address2: | |||||||||
| City: | CORDOVA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380186504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9018210338 | ||||||||
| FaxNumber: | 9015078298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2019 | ||||||||
| LastUpdateDate: | 05/23/2019 | ||||||||
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| AuthorizedOfficialLastName: | PERRY | ||||||||
| AuthorizedOfficialFirstName: | FELESHA | ||||||||
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| AuthorizedOfficialTitleorPosition: | AUTHROIZED OFFICIAL/SOLE OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9014880089 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DPN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.