Individual provider · Type 1 NPI
Tracy Marie Widmer, CRNP
Pediatric Nurse Practitioner · Philadelphia, PA
NPI number
1760644546
Active
Practice location
3400 Civic Center Blvd
Philadelphia, PA 19104-4306
Mailing address
203 Stephanie Ct
Franklinville, NJ 08322-2699
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | UP006244D (PA) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1760644546
Tracy Marie Widmer, CRNP's National Provider Identifier is 1760644546, issued on Jul 2, 2008. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 2, 2008.