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General NPI Number Information
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NPI Number | 1619381340
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Entity Type | Individual
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Provider Name | ALYSSA KATHRYNE EZELL CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 610 AIRPORT RD SW STE 210
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City | HUNTSVILLE
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State | AL
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Zip | 35802-4304
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Country | US
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Telephone | 256-883-0098
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Fax | 256-883-0733
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Provider Business Mailing Address
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Address Line | 610 AIRPORT RD SW STE 210
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City | HUNTSVILLE
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State | AL
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Zip | 35802-4304
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Country | US
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Telephone | 256-883-0098
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Fax | 256-883-0733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0100X
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Taxonomy Name | Gastroenterology Registered Nurse
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License Number | 1-127404
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-127404
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License Number State | AL
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