1497181952 NPI number — DR. JILL KERLEY PALMA DC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497181952 NPI number — DR. JILL KERLEY PALMA DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALMA
Provider First Name:
JILL
Provider Middle Name:
KERLEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KERLEY
Provider Other First Name:
JILL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497181952
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
132 CEDAR ROCK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEEDS
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35094-8810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-699-6600
Provider Business Mailing Address Fax Number:
205-702-4877

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 HIGROVE PKWY
Provider Second Line Business Practice Location Address:
SUITE 113
Provider Business Practice Location Address City Name:
LEEDS
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35094-1703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-699-6600
Provider Business Practice Location Address Fax Number:
205-702-4877
Provider Enumeration Date:
09/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2389 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2389 . This is a "STATE LICENSE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com