Individual
TRACY MARIE WIDMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4306
(215) 590-1000
Mailing address
203 STEPHANIE CT, FRANKLINVILLE, NJ 08322-2699
(856) 629-6839
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
UP006244D
PA
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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