| Doctor Name: | MR. KEITH CHRISTOPHER PALM |
| NPI Number: | 1003888629 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | RN505912L |
| Business Practice Address: | Usa Meddac, Evans Army Community Hospital 1650 Cochrane Circle, Attn: Credentials Office Fort Carson, CO - 809134604 |
| Business Phone Number: | 7195267844 |
| Business Fax Number: | 7195267984 |
| Mailing Address: | 7922 Bayonet Cir, Apt B FORT CARSON |
| State: | CO |
| Postal Code: | 809134686 |
| Phone Number: | 7195594678 |
| Fax Number: | 7195263666 |
| NPI Enumeration Date: | 02/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN505912L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |