MEDICARE: RONNASIA G FERRELL

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	376K00000X	Nurse's Aide	346124	FL

General Provider Information

NPI Number	:	1548850019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONNASIA G FERRELL

Provider Business Mailing Address
First Line	:	1554 GOLF FOREST DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-6626
Country	:	US
Telephone Number	:	904-662-1522
Fax Number	:

Provider Business Practice Location Address
First Line	:	1554 GOLF FOREST DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32208-6626
Country	:	US
Telephone Number	:	904-662-1522
Fax Number	:

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

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	01/23/2021

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Directions to “ RONNASIA G FERRELL ” Practice Location

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