Individual
BODETTE JONELLE VAVRUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN, CA-CP SANE
Contact information
Practice address
506 E SAN ANTONIO ST, VICTORIA, TX 77901-6060
(361) 575-7441
Mailing address
3170 COUNTY ROAD 132, HALLETTSVILLE, TX 77964-4667
(361) 648-4398
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
804587
TX
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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