Individual
PENNY ANN PUKALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2386
(702) 383-1958
Mailing address
1800 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2329
(702) 383-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2491
NV
363A00000X
Physician Assistant
PA61120377
WA
Other
Enumeration date
09/09/2019
Last updated
10/29/2024
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