Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP128868 | TX |
NPI | 1003284688 |
---|---|
Provider Name | Pamela Palmer |
First Address | Dallas, TX 75284-4658 |
Second Address | Georgetown, TX 78628-3058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2015 |
Last Update Date | 26/10/2015 |