NPI 1598302739

Edna Mae Palmer

Practitioner Prevention Professional Malad City, ID

Practice location

Address: 3798 W 500 S, Malad City, ID 83252-6105
Phone: (208) 251-9808

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 32160 (ID)

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Registry record

NPI: 1598302739
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Dec 2019
Record last updated: 6 Dec 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.