TRACY A EZELLE ARNP NPI 1861410979

NPI Information

NPI: 1861410979
Provider Name: TRACY A EZELLE, ARNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
400 GULF BREEZE PKWY
SUITE 300
GULF BREEZE, FL
ZIP 32561
Phone: (850) 932-5055
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Tracy A Ezelle, ARNP is a pediatrics nurse practitioner in Gulf Breeze, FL. Tracy A Ezelle, ARNP NPI is 1861410979. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

400 GULF BREEZE PKWY
SUITE 300
GULF BREEZE, FL
ZIP 32561-495
Phone: (850) 932-5055
Fax: (850) 932-1404

The enumeration date for this NPI number is 7/17/2006 and was last updated on 1/10/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	ARNP2049062	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	307471400	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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