Individual
MATTHEW PANNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
200 HWY 30 W, NEW ALBANY, MS 38652-3112
(662) 538-2150
Mailing address
200 STATE HIGHWAY 30 W, NEW ALBANY, MS 38652-3112
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
905281
MS
363LF0000X
Family Nurse Practitioner
F03220787
MS
Other
Enumeration date
03/28/2022
Last updated
05/20/2022
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