| Doctor Name: | CAROL JOAN PALM |
| NPI Number: | 1023168002 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 84137 |
| Business Practice Address: | 2515 Broadway St Boulder, CO - 803044110 |
| Business Phone Number: | 3032450894 |
| Business Fax Number: | 3032450916 |
| Mailing Address: | 1019 Herman Pl, LONGMONT |
| State: | CO |
| Postal Code: | 805011802 |
| Phone Number: | 3037723084 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 84137 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |