Ezell, Susan L
Ezell, Susan L is an individual health care provider with primary practice located at 3901 Parkway Cir , Springdale AR 72762-6362. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Ezell, Susan L can be contacted via phone (479) 587-1700.Contact Information
Primary practice address
3901 Parkway Cir
Springdale AR 72762-6362
Phone: (479) 587-1700
Fax: (479) 587-1366
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | A005494 | Arkansas |
Profile Details
| NPI number | 1114427549 |
|---|---|
| LBN Legal business name | Ezell, Susan L |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 12th, 2018 |
| Last updated | Jul 20th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114427549 | NPPES |
| Arkansas | MEDICAID | 225616758 | |
| Arkansas | MEDICAID | 200758080A | |
| Arkansas | MEDICAID | 420051541 |
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