Provider Demographics
NPI:1124724604
Name:PALMER, JANE (RN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TOMAQUAG RD
Mailing Address - Street 2:
Mailing Address - City:ASHAWAY
Mailing Address - State:RI
Mailing Address - Zip Code:02804-3003
Mailing Address - Country:US
Mailing Address - Phone:401-741-2496
Mailing Address - Fax:
Practice Address - Street 1:4705 OLD POST RD UNIT A
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:RI
Practice Address - Zip Code:02813-1842
Practice Address - Country:US
Practice Address - Phone:401-364-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN69657163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse