Individual
JASON P PALMATEER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
5340 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1470
(574) 237-1328
(574) 237-1348
Mailing address
PO BOX 746092, ATLANTA, GA 30374-6092
(574) 334-5400
(574) 237-1348
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001595B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000730740
ANTHEM
IN
05
—
200862230
—
IN
Enumeration date
11/11/2005
Last updated
11/15/2023
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