Individual
CODY JAMES PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
50 NORTHGATE INDUSTRIAL DR, GRANITE CITY, IL 62040-6805
(618) 877-4420
Mailing address
448 WYLIE DR, NORMAL, IL 61761-5405
(888) 924-3786
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209025645
IL
363LF0000X
Family Nurse Practitioner
Primary
209025645
IL
Other
Enumeration date
01/26/2021
Last updated
08/21/2024
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