Individual
MRS. MELISSA ANN EZELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6414 HWY 98 W, SUITE 120, HATTIESBURG, MS 39402-3940
(601) 296-2833
Mailing address
23 CLINTON RD, HATTIESBURG, MS 39402-9709
(601) 519-2703
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R871458
MS
363LF0000X
Family Nurse Practitioner
Primary
904880
MS
Other
Enumeration date
02/17/2020
Last updated
10/08/2021
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