Individual
BRITTANY WIDEBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PN
Contact information
Practice address
141 COMMUNICATION DR, HANNIBAL, MO 63401-3670
(573) 603-1460
(573) 603-1462
Mailing address
118 N 2ND ST STE 200, SAINT CHARLES, MO 63301-2894
(636) 224-1210
(636) 946-0991
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2019037646
MO
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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