Provider Demographics
NPI:1871313890
Name:PALMER, JORDAN (HOLISTIC HEALTH)
Entity type:Individual
Prefix:PROF
First Name:JORDAN
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:HOLISTIC HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4384 CLEARWATER WAY STE 190
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6493
Mailing Address - Country:US
Mailing Address - Phone:859-403-3385
Mailing Address - Fax:
Practice Address - Street 1:4384 CLEARWATER WAY STE 190
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-6493
Practice Address - Country:US
Practice Address - Phone:859-403-3385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 171100000X, 171400000X, 175F00000X, 175L00000X, 174H00000X
KY1241971822084B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171100000XOther Service ProvidersAcupuncturist
No171400000XOther Service ProvidersHealth & Wellness Coach
No175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath
No2084B0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyObesity Medicine