| Doctor Name: | LEA PANNELLA |
| NPI Number: | 1518914944 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 002559 |
| Business Practice Address: | 1153 East Street South Macdougall Walker Correctional Institution Suffield, CT - 06078 |
| Business Phone Number: | 8606272290 |
| Business Fax Number: | |
| Mailing Address: | 1153 East Street South, Macdougall Walker Correctional Institution SUFFIELD |
| State: | CT |
| Postal Code: | 06078 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/30/2006 |
| NPI Last Update Date: | 04/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 002559 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |