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General NPI Number Information
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NPI Number | 1407806862
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Entity Type | Individual
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Provider Name | MARYANN CATHRINE WIDZINS RN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 9212 74TH PL
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City | KENOSHA
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State | WI
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Zip | 53142-8102
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Country | US
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Telephone | 262-697-8343
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Fax |
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Provider Business Mailing Address
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Address Line | 9212 74TH PL
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City | KENOSHA
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State | WI
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Zip | 53142-8102
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Country | US
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Telephone | 262-697-8343
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 51824-030
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License Number State | WI
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