Provider Demographics
NPI:1366985855
Name:PALMER, ERIC (DNP, PMHNP-BC, FNP-C)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:DNP, PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 4TH ST N # 13695
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:321-334-3742
Mailing Address - Fax:480-864-6048
Practice Address - Street 1:6470 WAY POINT BLVD
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:FL
Practice Address - Zip Code:34773-6160
Practice Address - Country:US
Practice Address - Phone:321-334-3742
Practice Address - Fax:480-864-6048
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9328774363LA2100X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1366710170Medicaid
FL1366710170Medicaid