Provider Demographics
NPI:1447542998
Name:PALMER, KAREN ELIZABETH (RDLDIN)
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:PALMER
Suffix:
Gender:F
Credentials:RDLDIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6891 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458
Mailing Address - Country:US
Mailing Address - Phone:561-842-5298
Mailing Address - Fax:561-842-5187
Practice Address - Street 1:700 OLD DIXIE HWY
Practice Address - Street 2:ST 105
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403
Practice Address - Country:US
Practice Address - Phone:561-842-5298
Practice Address - Fax:561-842-5187
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
FLND3435133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist