Individual
REBECCA JEAN WIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
805 PAMPLICO HWY, FLORENCE, SC 29505-6047
(843) 674-5000
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22588
SC
Other
Enumeration date
10/10/2019
Last updated
02/04/2021
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