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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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PANNELL, JARRETT WESTON       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 2225 N. MAIN STREET
MIAMI OK 74354

Address last updated on 12/29/2023
Phone #: (918) 542-4101
Fax #:
County: OTTAWA
License: 5964
Dated: 5/28/2021
Expires: 1/31/2025
License Type: Physical Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
2225 N. MAIN STREET
MIAMI OK 74354

Phone #: (918) 542-4101
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
NICHOLAS RAY BARON TA 3136
TORI MAKENZI BOYD TA 3463
JULIE LYNN BUCHANAN TA 604
MORIAH KAYE CLINE TA 2317
BRADEN G CRAWFORD TA 3605
LYDIA JANE CRAWFORD TA 3841
RYLEE ELIZABETH HAMMONS TA 2993
TALEASHA LAKAY HARVEY TA 3457
MIKE LEE MOODY TA 1854
KAILEY DAWN PEREZ TA 3720
NICHOLAS SHANE RANDOLPH TA 2852
MICHAEL BROOKS VICTOR TA 3168
JESSICA MAE WALKER TA 3304

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