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General NPI Number Information
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NPI Number | 1083610547
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Entity Type | Individual
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Provider Name | ROSE DAWN WIDENER NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 7105 RAMSEY WAY
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City | DICKSON
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State | TN
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Zip | 37055-1586
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Country | US
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Telephone | 615-446-4999
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Fax | 615-326-0099
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Provider Business Mailing Address
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Address Line | 5105 RHETT DR
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City | NASHVILLE
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State | TN
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Zip | 37211-5904
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Country | US
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Telephone | 615-516-3840
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN0000011005
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License Number State | TN
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