Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 2057 | HI |
Y | 363LW0102X | Nurse Practitioner - Women's Health | 0993619 | CO |
N | 363LW0102X | Nurse Practitioner - Women's Health | 2057 | HI |
NPI | 1043768252 |
---|---|
Provider Name | Kristin Palmore |
First Address | Peyton, CO 80831-4445 |
Second Address | Colorado Springs, CO 80919-2334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2016 |
Last Update Date | 21/03/2018 |