Individual
MATTHEW REESE PANNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
118 FAIRFIELD DR, NEW ALBANY, MS 38652-3107
(662) 534-0898
(662) 534-8905
Mailing address
118 FAIRFIELD DR, NEW ALBANY, MS 38652-3107
(662) 534-0898
(662) 534-8905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905281
MS
363LF0000X
Family Nurse Practitioner
F03220787
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007805871
—
MS
Enumeration date
03/28/2022
Last updated
08/11/2026
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