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Individual

LAURA PALMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
4855 S MOORLAND RD # ROD, NEW BERLIN, WI 53151-7494
(262) 432-7599
Mailing address
5558 N IROQUOIS AVE, GLENDALE, WI 53217-5014

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
8171-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1639685274
WI
Enumeration date
12/19/2017
Last updated
12/21/2017
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