Individual provider Active NPI

Sandra H Palmer, ARNP-C

  • Gerontology Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1174588404
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
ARNP 891762 Issued in FL
Practice address
204 E 19TH St
Panama City, FL 32405-4707
Phone
(850) 763-5409
Fax
(850) 763-7129
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP 891762 FL Primary

Addresses

Primary practice location

204 E 19TH St
Panama City, FL 32405-4707

Mailing address

204 E 19TH St
Panama City, FL 32405-4707
Phone (850) 763-5409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 891762FLMDGerontology Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1174588404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054707",
            "telephone_number": "850-763-5409",
            "fax_number": "850-763-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 19TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054707",
            "telephone_number": "850-763-5409",
            "fax_number": "850-763-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "SANDRA",
        "middle_name": "H",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP 891762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.