Individual
MRS. REBECCA BULLARD EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1850 GAUSE BLVD E STE 101, SLIDELL, LA 70461-5454
(985) 639-3777
(985) 661-3578
Mailing address
1850 GAUSE BLVD E STE 101, SLIDELL, LA 70461-5454
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP09916
LA
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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