Provider Demographics
NPI:1699090597
Name:PALMER, ZENOVIA L (MS)
Entity type:Individual
Prefix:MS
First Name:ZENOVIA
Middle Name:L
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3174 IMPERIAL CIR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-5209
Mailing Address - Country:US
Mailing Address - Phone:404-783-1814
Mailing Address - Fax:
Practice Address - Street 1:3174 IMPERIAL CIR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-5209
Practice Address - Country:US
Practice Address - Phone:404-783-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
GAMT005318225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist