Individual
NICOLE EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13352 ARGYLE ST, SOUTHGATE, MI 48195-1249
(734) 775-2783
Mailing address
13352 ARGYLE ST, SOUTHGATE, MI 48195-1249
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704334116
MI
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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