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Individual

MS. KIM R MARTIN-WIDAWSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANPC

Contact information

Practice address
328 W SAINT GEORGES AVE, LINDEN, NJ 07036-5638
(908) 925-2273
Mailing address
77 W MAPLE AVE, ALLENDALE, NJ 07401-1206
(201) 394-3329

Taxonomy

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

Other

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
Enumeration date
11/16/2006
Last updated
02/05/2025
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