Individual
MRS. CARRIE RENEE WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1 MEDICAL PARK BLVD STE 300E, BRISTOL, TN 37620-7497
(423) 844-6450
Mailing address
1 MEDICAL PARK BLVD STE 300E, BRISTOL, TN 37620-7497
(423) 844-6450
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26733
TN
Other
Enumeration date
10/25/2019
Last updated
04/03/2020
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