MEDICARE: ERIN EZELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer	3350	TN
3	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1881373629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN EZELL

Provider Business Mailing Address
First Line	:	222 THOMPSON PARK DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-2685
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 UNIVERSITY PARK DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-3956
Country	:	US
Telephone Number	:	810-471-8606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	05/19/2026

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Practice Location Address:

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Directions to “ ERIN EZELL ” Practice Location

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