Provider Demographics
NPI:1902356546
Name:PALMER, REBECCA DANIELLE (CNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DANIELLE
Last Name:PALMER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12000 MCCRACKEN RD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2964
Mailing Address - Country:US
Mailing Address - Phone:216-475-5370
Mailing Address - Fax:216-475-5125
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:SUITE 460
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125
Practice Address - Country:US
Practice Address - Phone:216-475-5370
Practice Address - Fax:216-475-5125
Is Sole Proprietor?:No
Enumeration Date:2016-10-06
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020009363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health