Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | E4866 | AR |
NPI | 1124128467 |
---|---|
Provider Name | Kricia P Palmer |
First Address | Little Rock, AR 72227-2303 |
Second Address | Little Rock, AR 72227-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 07/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06080015700 | QULCHOICE (01) | AR |
163877001 | (05) | AR |
P00381023 | RAILROAD MEDICARE (01) | AR |