Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1104164904 |
---|---|
Provider Name | Kimberly K Palmer |
First Address | Post Falls, ID 83854-6911 |
Second Address | Post Falls, ID 83854-6911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2013 |
Last Update Date | 29/01/2013 |