Individual
MELISSA MARIE PANNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN FNP-BC
Contact information
Practice address
3280 E LANARK DR, MERIDIAN, ID 83642-5982
(208) 895-8670
(208) 955-0494
Mailing address
10482 W CARLTON BAY DR, GARDEN CITY, ID 83714-5143
(208) 955-6500
(208) 955-6501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN148673
AZ
363L00000X
Nurse Practitioner
Primary
1971656
ID
363LF0000X
Family Nurse Practitioner
Primary
AP5308
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
882418
—
AZ
Enumeration date
04/29/2013
Last updated
06/18/2026
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