# MS. KIM R MARTIN-WIDAWSKY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1053484147
- **Gender:** F
- **Credential:** ANPC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WX0106X | Occupational Health Registered Nurse | 26NN06683300 | NJ | — |
| 163WX0106X | Occupational Health Registered Nurse | 300344 | NY | — |
| 363L00000X | Nurse Practitioner | 26NN06683300 | NJ | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | 300344 | NY | — |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 02/05/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 26NN06683300 | ADVANCE PRACTICE NURSE | NJ |
| 01 | — | 300344 | RN ANP LICENSE | NY |
| 01 | — | F300344-1 | NURSE PRACTITIONER IN ADULT HEALTH | NY |