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Individual
KELLY GRANT EZZELL
Active
Individual
KELLY GRANT EZZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
ARNP9384638
FL
363L00000X
Nurse Practitioner
ARNP9384638
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
319192
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022054500
—
FL
Enumeration date
07/27/2017
Last updated
07/10/2026
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