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Individual

MRS. MICHELLE PANNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CST, LSA

Contact information

Practice address
2104 BUILDER RD, CROWLEY, TX 76036-4611
(817) 675-8299
Mailing address
2104 BUILDER RD, CROWLEY, TX 76036-4611
(817) 675-8299

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00566
TX
246ZS0410X
Surgical Technologist
143701
TX

Other

Enumeration date
12/22/2014
Last updated
06/19/2017
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