Individual
LEA PANNELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11361 N 99TH AVE, PEORIA, AZ 85345-5470
(602) 686-0609
(602) 636-5283
Mailing address
11361 N 99TH AVE, PEORIA, AZ 85345-5470
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP10827
AZ
Other
Enumeration date
05/30/2006
Last updated
01/12/2025
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