Jill Marie Christine Dewitt, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

1012876 Issued in TX

Practice address

110 Dellwood CT
La Marque, TX 77568-2014

Phone

(051) 660-4679

NPI assigned

Jun 23, 2021

Last updated

Jun 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jill Marie Christine Bradley Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1356910327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 DELLWOOD CT",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775682014",
            "telephone_number": "951-660-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DELLWOOD CT",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775682014",
            "telephone_number": "051-660-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "JILL",
        "middle_name": "MARIE CHRISTINE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "1012876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "BRADLEY",
            "middle_name": "MARIE CHRISTINE",
            "credential": "LVN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Licensed Vocational Nurse in La Marque, TX
• Providers in La Marque, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.