Individual
LORRAINE KAY WIDDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
8317 CALUMET AVE, MUNSTER, IN 46321-1737
(219) 513-2333
(219) 513-1127
Mailing address
8317 CALUMET AVE, MUNSTER, IN 46321-1737
(219) 513-2333
(219) 513-2334
Taxonomy
Speciality
Code
Description
License number
State
364SM0705X
Medical-Surgical Clinical Nurse Specialist
Primary
28087637A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200473170
—
IN
Enumeration date
05/11/2006
Last updated
04/20/2015
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