Individual
MRS. REBECCA WIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
29200 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1274
(586) 777-7577
Mailing address
29200 HARPER AVE, SAINT CLAIR SHORES, MI 48081-1274
(586) 777-7577
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704270250
MI
Other
Enumeration date
06/14/2016
Last updated
12/12/2020
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