Individual
STANTON W EZZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
703 NEWMAN RD, NEW BERN, NC 28562-5239
(252) 635-5290
(252) 633-9609
Mailing address
703 NEWMAN RD, NEW BERN, NC 28562-5239
(252) 635-5290
(252) 633-9609
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
300311
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300311
NC MEDICAL LICENSE
NC
Enumeration date
11/20/2006
Last updated
07/08/2007
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