Provider Demographics
NPI:1851986285
Name:PALMER, CATHERINE THEODOSIA (CNM, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:THEODOSIA
Last Name:PALMER
Suffix:
Gender:
Credentials:CNM, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3425
Mailing Address - Country:US
Mailing Address - Phone:781-330-4660
Mailing Address - Fax:
Practice Address - Street 1:930 MLK BLVD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2656
Practice Address - Country:US
Practice Address - Phone:919-338-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
367076OtherNC BOARD OF NURSING
CNM06860OtherAMERICAN MIDWIFERY CERTIFICATION BOARD
L-13597OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS
CNM172OtherNC BOARD OF NURSING