Individual
TRACY A EZELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
400 GULF BREEZE PKWY STE 300, GULF BREEZE, FL 32561-4458
(850) 932-5055
(850) 932-1404
Mailing address
PO BOX 280, GULF BREEZE, FL 32562-0280
(850) 932-5055
(850) 932-1404
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP2049062
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307471400
—
FL
Enumeration date
07/17/2006
Last updated
01/23/2024
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