person
Stacy Wideman
Psychiatric/Mental Health Nurse Practitioner in Doral, Florida
NPI 1386243871

Stacy Wideman is a Psychiatric/Mental Health Nurse Practitioner based in Duluth, FL and is specialized in Psychiatric/Mental Health. Stacy Wideman practices in Doral, FL. The NPI Number for Stacy Wideman is 1386243871 and holds a License No. C-RXN.0001379 (Florida).

The current practice location address for Stacy Wideman is 8450 Nw 102Nd Ave, Doral, FL and can be reached out via phone at 360-643-6562. You can also correspond with Stacy Wideman through the mailing address at 3235 SATELLITE BLVD STE 300, DULUTH, GA - 30096-8688 (mailing address contact number: 360-643-6562).

Location: 8450 Nw 102Nd Ave, Doral, FL, 30096-8688
person
Provider Profile Details
NPI Number
1386243871
Provider Name
Stacy Wideman
Credential
Provider Entity Type
Individual
Gender
Female
Address
8450 Nw 102Nd Ave, Doral, FL, 30096-8688
Phone Number
360-643-6562
Fax Number
Provider Enumeration Date
10/26/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
8450 Nw 102Nd Ave
City
State
Zip
33178-4750
Phone Number
360-643-6562
Fax Number
person
Provider Business Mailing Address Details
Address
8450 Nw 102Nd Ave
City
State
Zip
33178-4750
Phone Number
360-643-6562
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
C-RXN.0001379 (Colorado)
Definition
Definition to come...
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