Provider Demographics
NPI:1285251686
Name:PALMER, ALLANE J (CNA)
Entity type:Individual
Prefix:MISS
First Name:ALLANE
Middle Name:J
Last Name:PALMER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WYONIA WAY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-2421
Mailing Address - Country:US
Mailing Address - Phone:404-454-8297
Mailing Address - Fax:
Practice Address - Street 1:100 WYONIA WAY
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-2421
Practice Address - Country:US
Practice Address - Phone:404-454-8298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide