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General NPI Number Information
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NPI Number | 1336499243
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Entity Type | Individual
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Provider Name | VERENA PANNELL MCGINNIS APMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 2495 SHREVEPORT HWY # 71 #116
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City | PINEVILLE
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State | LA
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Zip | 71360-4044
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Country | US
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Telephone | 318-473-0010
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 69004
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City | ALEXANDRIA
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State | LA
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Zip | 71306-9004
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Country | US
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Telephone | 318-466-2276
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP07004
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License Number State | LA
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