Healthcare Provider Details

I. General information

NPI: 1831376532
Provider Name (Legal Business Name): CINDY JEAN WIDMYER NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4200
  • Fax: 513-862-4189
Mailing address:
  • Phone: 513-862-2514
  • Fax: 513-862-4189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberCOA.13880-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberCOA.13880-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: