Provider Demographics
NPI:1578301685
Name:PALMER, KARA BROOKE (FNP-C)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:BROOKE
Last Name:PALMER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 BOB O LINK RD
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75645-7340
Mailing Address - Country:US
Mailing Address - Phone:903-720-8514
Mailing Address - Fax:
Practice Address - Street 1:419 WSW LOOP 323 STE 200
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-7061
Practice Address - Country:US
Practice Address - Phone:430-625-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168970363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner