Individual
EZRAH GUNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1110 CLAY ST, VICKSBURG, MS 39183-2912
(601) 738-5820
Mailing address
1110 CLAY ST, VICKSBURG, MS 39183-2912
(601) 738-5820
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
902374
MS
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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