Individual
MRS. FELICIA EZELL-GOODNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1100 SW 89TH ST, OKLAHOMA CITY, OK 73139-9104
(405) 632-7256
Mailing address
1100 SW 89TH STREET, OKLAHOMA CITY, OK 73139
(405) 632-7256
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
76100
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05115683930
—
OK
Enumeration date
08/28/2016
Last updated
08/28/2016
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