Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | A0911065 | MN |
NPI | 1013284975 |
---|---|
Provider Name | Ms. Judy Lee Palmer |
First Address | Minneapolis, MN 55413-1761 |
Second Address | Cedar, MN 55011-9413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2011 |
Last Update Date | 19/12/2019 |