Individual
SAMANTHA D WIDMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 N OREGON ST, EL PASO, TX 79902-3320
(915) 873-9657
Mailing address
820 GOLD BEACH DR, CANUTILLO, TX 79835-8466
(915) 873-9657
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
860322
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
1112933
TX
Other
Enumeration date
02/17/2023
Last updated
07/31/2023
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