Provider Demographics
NPI:1154803492
Name:PALMER, FAWN HELENE (PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:FAWN
Middle Name:HELENE
Last Name:PALMER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-0624
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:6363 FOREST PARK RD 7TH FL STE 749
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-1013
Practice Address - Country:US
Practice Address - Phone:214-645-8500
Practice Address - Fax:214-648-3775
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEL8-0000160363LP0808X
TX1047898363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health