Doctor Name: | JENS KERSTEN PALMER |
NPI Number: | 1063638435 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ANP-C |
License Number: | 5004433 |
Business Practice Address: | 293 Olmsted Blvd Suite 4 Pinehurst, NC - 283749181 |
Business Phone Number: | 9102953200 |
Business Fax Number: | 9102953222 |
Mailing Address: | 293 Olmsted Blvd, Suite 4 PINEHURST |
State: | NC |
Postal Code: | 283749181 |
Phone Number: | 9102953200 |
Fax Number: | 9102953222 |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 01/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 5004433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |