Jacqueline Minard Reddell, LVN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

211850 Issued in TX

Practice address

10703 RR 12
Wimberley, TX 78676-5239

Phone

(737) 268-5610

Fax

(512) 690-0171

NPI assigned

Dec 28, 2021

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

Other names 1

• Jacqueline Minard Bannister 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": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644105600000",
    "number": "1992465249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10703 RR 12",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765239",
            "telephone_number": "737-268-5610",
            "fax_number": "512-690-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10703 RR 12",
            "city": "WIMBERLEY",
            "state": "TX",
            "postal_code": "786765239",
            "telephone_number": "737-268-5610",
            "fax_number": "512-690-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDELL",
        "first_name": "JACQUELINE",
        "middle_name": "MINARD",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "211850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "BANNISTER",
            "middle_name": "MINARD",
            "credential": "LVN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Price, MD
• Roger Devern Pruitt, D.O.
• Alex Ramirez, PT
• Juan Ivan Ramirez, M.D.
• John Ransone, PHD, ATC
• Resurgence Texas
• Vivian Louese Risch, PHYSICIAL THERAPIST
• Gina Risher, LPC-ASSOCIATE
• Riverside Keepers LLC
• Robert D White DDS

• Licensed Vocational Nurse in Wimberley, TX
• Providers in Wimberley, 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 Feb 6, 2022; 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.