Individual
JESSE FERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
224 W DL. INGRAM AVE, BLDG 1408, CANNON AFB, NM 88101
(575) 784-8512
Mailing address
224 W D.L. INGRAM AVE, BLDG 1408, CANNON AFB, NM 88103
(575) 784-8512
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
01/17/2025
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