Provider Demographics
NPI:1619024833
Name:PARNELL, PAULA MICHELLE (ATC)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:MICHELLE
Last Name:PARNELL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-8118
Mailing Address - Country:US
Mailing Address - Phone:870-761-3497
Mailing Address - Fax:
Practice Address - Street 1:2120 MANCHESTER DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-8118
Practice Address - Country:US
Practice Address - Phone:870-761-3497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer