Provider Demographics
NPI:1174110787
Name:PALMER, RACHEL MICHELLE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MICHELLE
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 33RD ST NE APT C
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-3883
Mailing Address - Country:US
Mailing Address - Phone:330-437-8213
Mailing Address - Fax:
Practice Address - Street 1:3203 33RD ST NE APT C
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-3883
Practice Address - Country:US
Practice Address - Phone:330-437-8213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health