Individual
MICHELLE B WIDMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-1000
(781) 744-8460
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
071057-23
NH
363L00000X
Nurse Practitioner
AP60310471
WA
363L00000X
Nurse Practitioner
Primary
RN2270499
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3100668
—
NH
Enumeration date
11/05/2012
Last updated
09/17/2021
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