Individual
MR. NICKOLAS WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 406-4343
Mailing address
6632 SPRINGFIELD VILLAGE LN, CLEMMONS, NC 27012-8986
(336) 406-4343
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6537
NC
Other
Enumeration date
02/02/2021
Last updated
05/13/2021
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