Provider Demographics
NPI:1336629336
Name:MCDONELL, JENNIFER (LVN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MCDONELL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3427 WHISPER BR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2313
Mailing Address - Country:US
Mailing Address - Phone:210-636-8849
Mailing Address - Fax:
Practice Address - Street 1:5726 W HAUSMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249
Practice Address - Country:US
Practice Address - Phone:210-349-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-19
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX219116164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse