Individual
MRS. MARYANN CATHRINE WIDZINS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
9212 74TH PL, KENOSHA, WI 53142-8102
(262) 697-8343
Mailing address
9212 74TH PL, KENOSHA, WI 53142-8102
(262) 697-8343
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
51824-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C38202100
—
WI
Enumeration date
05/10/2006
Last updated
07/09/2007
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