Provider Demographics
NPI:1730916750
Name:PALKA, PATRICIA ANN (FDN-P)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:PALKA
Suffix:
Gender:F
Credentials:FDN-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7608 CHERRYHILL DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-7375
Mailing Address - Country:US
Mailing Address - Phone:719-459-9887
Mailing Address - Fax:
Practice Address - Street 1:7608 CHERRYHILL DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-7375
Practice Address - Country:US
Practice Address - Phone:719-459-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator