Individual
AMANDA SALEE WIDAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 HIGHVIEW BLVD, COLUMBUS, OH 43207-6023
(513) 941-9999
Mailing address
6460 HARRISON AVE STE 200, CINCINNATI, OH 45247-7958
(513) 941-4999
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.191222
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099345
—
OH
Enumeration date
02/19/2025
Last updated
02/24/2025
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