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Individual

JUDITH E WIDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
3901 RAINBOW BLVD MSC 4043, 2032 SCHOOL OF NURSING, KANSAS CITY, KS 66160-0001
(866) 249-9736
Mailing address
PO BOX 9418, THE WOODLANDS, TX 77387-9418
(866) 249-9736

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1099
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16863037
BCBS PROVIDER #
Enumeration date
08/18/2006
Last updated
07/08/2007
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