Individual
GLORIA ANN EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
367 COUNTY ROAD 475, DE LEON, TX 76444-6323
(501) 984-1585
Mailing address
367 COUNTY ROAD 475, DE LEON, TX 76444-6323
(501) 984-1585
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
219997
TX
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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