IndividualActive
Jerrica Wild
NPI 1003109844 · Independent Duty Medical Technicians · Beale Afb, CA
Provider details
- NPI number
- 1003109844
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Sex
- Female
- Sole proprietor
- No
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Registry dates
- Enumerated
- 2011-05-26
- Last updated
- 2011-11-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.