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Individual

JODI MARIE PALMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3648 W ANTHEM WAY, BLDG. A-100,, ANTHEM, AZ 85086-7001
(623) 434-6444
(623) 434-6448
Mailing address
2500 W UTOPIA RD, SUITE 100, PHOENIX, AZ 85027-4171
(623) 434-6200
(623) 434-6164

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP7676
AZ
363LF0000X
Family Nurse Practitioner
F0215444
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Z25025
MEDICARE PTAN
AZ
Enumeration date
05/28/2015
Last updated
01/12/2016
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