Vickie Lynn Maywald, RN

Key facts

NPI

1669067229

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

595849 (TX)

Practice address

20403 Timber Ridge Dr
Magnolia, TX 77355-4969

Phone

(281) 356-9592

NPI assigned

Mar 5, 2021

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 5, 2021.

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1669067229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20403 TIMBER RIDGE DR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773554969",
            "telephone_number": "281-356-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20403 TIMBER RIDGE DR",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773554969",
            "telephone_number": "281-356-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYWALD",
        "first_name": "VICKIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "595849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Magnolia, TX · Registered Nurse in Texas