Individual
KAREN M PENNELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
470 NORTHSIDE CHEROKEE BLVD STE 170, CANTON, GA 30115-8029
(770) 721-9540
(770) 721-9541
Mailing address
3400 OLD MILTON PKWY # C, SUITE 290, ALPHARETTA, GA 30005-3707
(770) 667-4337
(770) 667-4338
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008027
GA
363A00000X
Physician Assistant
784
MA
363AS0400X
Surgical Physician Assistant
PA784
MA
Other
Enumeration date
09/27/2006
Last updated
04/14/2020
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