Individual provider Active NPI

Brenda Jean Palmer, RN BSN

  • Long-Term Care Clinical Nurse Specialist
  • Okemos, MI
National Provider Identifier
1336717404
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long-Term Care Clinical Nurse SpecialistTaxonomy code 364SL0600X
License
4704155089 Issued in MI
Practice address
4830 Central Park Dr
Okemos, MI 48864-2089
Phone
(517) 349-3600
Fax
(517) 349-3602
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long-Term Care Clinical Nurse Specialist 364SL0600X 4704155089 MI Primary

Addresses

Primary practice location

4830 Central Park Dr
Okemos, MI 48864-2089

Mailing address

4830 Central Park Dr
Okemos, MI 48864-2089
Phone (517) 349-3600

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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704155089MIMDLong-Term Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1336717404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 CENTRAL PARK DR",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642089",
            "telephone_number": "517-349-3600",
            "fax_number": "517-349-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 CENTRAL PARK DR",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642089",
            "telephone_number": "517-349-3600",
            "fax_number": "517-349-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "BRENDA",
        "middle_name": "JEAN",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SL0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Long-Term Care",
            "state": "MI",
            "license": "4704155089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.