Provider Demographics
NPI:1720661358
Name:TAYLOR-PALMER, JASSETH MANNEISA (WHNP-BC)
Entity type:Individual
Prefix:
First Name:JASSETH
Middle Name:MANNEISA
Last Name:TAYLOR-PALMER
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 NEW HOPE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLOW ROCK
Mailing Address - State:TN
Mailing Address - Zip Code:38342-2250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2560 NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:HOLLOW ROCK
Practice Address - State:TN
Practice Address - Zip Code:38342-2250
Practice Address - Country:US
Practice Address - Phone:731-535-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR235691363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health