Kelly Grant Ezzell, ARNP is a medicare enrolled "Nurse Practitioner - Pediatrics" physician in Wilmington, North Carolina. Her current practice location is
1501 Dock St, Wilmington, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(910) 254-9898.
Kelly Grant Ezzell is licensed to practice in North Carolina (license number 319192) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1760906184.
Physician's Profile
Full Name | Kelly Grant Ezzell |
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Gender | Female |
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Speciality | Nurse Practitioner - Pediatrics |
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Location | 1501 Dock St, Wilmington, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1760906184
- Provider Enumeration Date: 07/27/2017
- Last Update Date: 10/29/2020
Medicare PECOS Information:
- PECOS PAC ID: 5991070740
- Enrollment ID: I20171005000062
Medical Identifiers
Medical identifiers for Kelly Grant Ezzell such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760906184 | NPI | - | NPPES |
022054500 | Medicaid | FL | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2088P0231X | Urology - Pediatric Urology | ARNP9384638 (Florida) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | 319192 (North Carolina) | Primary |
363L00000X | Nurse Practitioner | ARNP9384638 (Florida) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Grant Ezzell is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelly Grant Ezzell, ARNP 1501 Dock St, Wilmington, NC 28401-4936 Ph: (910) 254-9898 | Kelly Grant Ezzell, ARNP 1501 Dock St, Wilmington, NC 28401-4936 Ph: (910) 254-9898 |
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