Individual
DR. KEVIN PANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, CRNA
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(214) 687-0001
Mailing address
6225 N STATE HIGHWAY 161 STE 200, IRVING, TX 75038-2241
(214) 687-0001
(972) 518-2100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
891645
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1026882
TX
Other
Enumeration date
07/23/2020
Last updated
04/08/2021
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