Provider Demographics
NPI:1982841169
Name:BREDELL, JENNIFER J (RN)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:J
Last Name:BREDELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8530 SELENDINE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-2826
Mailing Address - Country:US
Mailing Address - Phone:210-221-7197
Mailing Address - Fax:
Practice Address - Street 1:8530 SELENDINE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-2826
Practice Address - Country:US
Practice Address - Phone:210-221-7197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO096542163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse