Individual
KRISTINA K WIDDIFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 W 4TH ST, STE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Mailing address
100 W 4TH ST, STE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
165246
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530800
—
TN
Enumeration date
12/12/2012
Last updated
01/16/2013
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