Provider Demographics
NPI:1124451422
Name:PALMA, JESSICA ANN (NP-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:PALMA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ANN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:4002 MAKALIKE PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-4455
Mailing Address - Country:US
Mailing Address - Phone:808-356-5614
Mailing Address - Fax:808-538-3957
Practice Address - Street 1:1401 S BERETANIA ST
Practice Address - Street 2:SUITE 750
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1870
Practice Address - Country:US
Practice Address - Phone:808-356-5614
Practice Address - Fax:808-538-3957
Is Sole Proprietor?:No
Enumeration Date:2013-08-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1564363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology