Kelly Grant Ezzell, ARNP - Medicare Nurse Practitioner in Wilmington, NC

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.

Contact Information

Kelly Grant Ezzell, ARNP
1501 Dock St,
Wilmington, NC 28401-4936
(910) 254-9898
Not Available



Physician's Profile

Full NameKelly Grant Ezzell
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location1501 Dock St, Wilmington, North Carolina
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1760906184NPI-NPPES
022054500MedicaidFL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2088P0231XUrology - Pediatric Urology ARNP9384638 (Florida)Secondary
363LP0200XNurse Practitioner - Pediatrics 319192 (North Carolina)Primary
363L00000XNurse 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 AddressPractice 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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