Provider Demographics
NPI:1780315267
Name:EZZELL, PAMELA ANN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:EZZELL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2517 HIGHWAY 180 W STE A
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8297
Mailing Address - Country:US
Mailing Address - Phone:940-325-3706
Mailing Address - Fax:940-325-6200
Practice Address - Street 1:2517 HIGHWAY 180 W STE A
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8297
Practice Address - Country:US
Practice Address - Phone:940-325-3706
Practice Address - Fax:940-325-6200
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1085710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily