Organization
SPAN HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY PANNELL NP (OWNER)
(601) 316-6775
Entity
Organization
Contact information
Practice address
422 BERKSHIRE DR, RIDGELAND, MS 39157-3622
(601) 316-6775
Mailing address
422 BERKSHIRE DR, RIDGELAND, MS 39157-3622
(601) 316-6775
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
10/24/2023
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