Individual
MRS. WILLETTA R.J. PALMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4500 FOREST DR, COLUMBIA, SC 29206-3105
(803) 738-9522
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
21873
SC
363LF0000X
Family Nurse Practitioner
Primary
21873
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21873
NURSING LICENSE
SC
05
—
NP5401
—
SC
Enumeration date
05/16/2007
Last updated
02/24/2025
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