MEDICARE: KYRA C 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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1144186321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRA C FERRELL

Provider Business Mailing Address
First Line	:	230 W 40TH ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32206-6444
Country	:	US
Telephone Number	:	904-229-5497
Fax Number	:

Provider Business Practice Location Address
First Line	:	6817 SOUTHPOINT PKWY STE 1201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6296
Country	:	US
Telephone Number	:	904-559-9071
Fax Number	:

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

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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Directions to “ KYRA C FERRELL ” Practice Location

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