Individual
MRS. DIANE R EZEKOYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1830 GOOD HOPE RD, ENOLA, PA 17025-1233
(717) 732-8877
(717) 732-9241
Mailing address
409 S 2ND ST STE 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP014145
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103046285
—
PA
Enumeration date
11/05/2014
Last updated
01/24/2018
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