Provider Demographics
NPI:1295249803
Name:PALMER, SHERRY REGINA
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:REGINA
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 1:2405 DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-6335
Mailing Address - Country:US
Mailing Address - Phone:843-455-1900
Mailing Address - Fax:
Practice Address - Street 1:2405 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-6335
Practice Address - Country:US
Practice Address - Phone:843-455-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management