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Individual
MATTHEW SEAN EZELLE
Active
Individual
MATTHEW SEAN EZELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-BC PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
40019
TN
363L00000X
Nurse Practitioner
95038005
CA
363LF0000X
Family Nurse Practitioner
40019
TN
363LF0000X
Family Nurse Practitioner
95038005
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
40019
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95038005
CA
Other
Enumeration date
10/14/2025
Last updated
05/01/2026
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