Individual
MRS. TINA LOUISE WIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
240 UNION STATION PLAZA, BETHLEHEM, PA 18015
(484) 526-2786
(484) 893-7096
Mailing address
240 UNION STATION PLAZA, BETHLEHEM, PA 18015
(484) 526-2786
(484) 893-7096
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-504154-L
PA
163WC1500X
Community Health Registered Nurse
Primary
RN505154L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029488650001
—
PA
Enumeration date
07/21/2014
Last updated
05/25/2016
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