Individual
MR. JEFFREY SORELLE PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD., WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
6143 SPRING FOREST DR, PFAFFTOWN, NC 27040-9356
(336) 945-9924
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
36140
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050231
—
NC
Enumeration date
12/02/2005
Last updated
09/14/2007
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