Bodette Jonelle Vavrusa, BSN, RN, CA-CP SANE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

804587 Issued in TX

Practice address

506 E San Antonio St
Victoria, TX 77901-6060

Phone

(361) 575-7441

NPI assigned

Nov 25, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1780400689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 COUNTY ROAD 132",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779644667",
            "telephone_number": "361-648-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E SAN ANTONIO ST",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779016060",
            "telephone_number": "361-575-7441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779043102",
            "country_code": "US",
            "telephone_number": "361-573-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAVRUSA",
        "first_name": "BODETTE",
        "middle_name": "JONELLE",
        "credential": "BSN, RN, CA-CP SANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "804587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Nicole Varela
• Ninu Varughese, PHARMD
• Vasavada Medical Consultants
• Rasendu J Vasavada, MD
• John W Vaughan, MD
• Javier M Vazquez Ortiz, M.D.
• Arthur Rene Vega, PHARMACY TECHNICIAN
• Cesar Baquiran Velasco, M.D.
• Maria Christina Velasco, M.D.
• Jesse David Velez, FNP-C

• Registered Nurse in Victoria, TX
• Providers in Victoria, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.