Individual
KRISTY EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
934 WEST DR, LAUREL, MS 39440-4702
(601) 426-7520
(601) 428-5790
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
(601) 705-1952
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P316351
MS
Other
Enumeration date
06/29/2021
Last updated
07/07/2021
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