PATRICIA DIANE WIDENOJA (NPI# 1235110628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235110628 |
| Entity Type | Individual |
| Full Name | PATRICIA DIANE WIDENOJA |
| Credential | BSN, MN, FNP |
| Practice Address |
85955 Raven Ridge Ln Silver Lake OR 97638-9627 |
| Practice Telephone | 5415763070 |
| Practice Fax Number | 5415763070 |
| Mailing Telephone | 5415763070 |
| Mailing Fax Number | 5415763070 |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2020-10-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
078041667N1 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | DEA | MWOO73609 | 01 |
| OR | WORKERS COMPENSATION | ANP0170 | 01 |
| OR | 051750 | 05 |
| Street Address |
85955 RAVEN RIDGE LN |
| City | SILVER LAKE |
| State | OR |
| Zip Code | 97638-9627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467848978 | Wellness Nursing's Way, Inc. | Clinic/Center | 85955 Raven Ridge Ln, Silver Lake, OR 97638-9627 | 2015-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235208083 | Silver Lake Rural Fire Protection District | Ambulance | 53224 4th Street, Silver Lake, OR 97638 | 2006-11-07 |
| 1033680715 | Lake County School Dist. #14 | Local Education Agency (LEA) | 57566 Fort Rock Rd, Silver Lake, OR 97638-9629 | 2018-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083238331 | Brooke Ann Huffman | Registered Nurse | 5332 W 1300 S, Silver Lake, IN 46982-8528 | 2020-06-02 |
| 1437793478 | Michael John Paul Sokolski | Specialist/Technologist | 112 W Depot St, Silver Lake, WI 53170-1531 | 2019-11-02 |
| 1033680715 | Lake County School Dist. #14 | Local Education Agency (LEA) | 57566 Fort Rock Rd, Silver Lake, OR 97638-9629 | 2018-12-06 |
| 1568931541 | Kenosha Community Health Center, Inc | Clinic/Center | 903 S 2nd St, Silver Lake, WI 53170-1747 | 2018-11-19 |
| 1609384676 | A2b Transportation LLC | Non-emergency Medical Transport (VAN) | 110 Century Ln, Silver Lake, MN 55381-6174 | 2018-01-11 |
| 1376058941 | Kendra Maksen | Speech-Language Pathologist | 114 W Elm St, Silver Lake, WI 53170-1509 | 2017-12-05 |
| 1316482383 | Natural Fit LLC | Prosthetic/Orthotic Supplier | 408 Circle Dr, Suite C, Silver Lake, KS 66539-9520 | 2016-12-30 |
| 1134571979 | Sarah Zuch | Physical Therapist | 2980 Silver Lake Blvd, Silver Lake, OH 44224-3035 | 2016-07-05 |
| 1033583059 | Kristin Weaver | Speech-Language Pathologist | 3016 Vincent Rd, Silver Lake, OH 44224-2947 | 2015-11-16 |
| 1184096604 | Barry Kiernan | Speech-Language Pathologist | 3121 E Edgerton Rd, Silver Lake, OH 44224-3108 | 2015-10-23 |
| Find all providers in SILVER LAKE | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484631 | Dana Marie Hampton | Nurse Practitioner | 2474 Sw Perkins Ave, Pendleton, OR 97801-4302 | 2020-10-13 |
| 1730796525 | Eden Fair | Nurse Practitioner | 841 E Cascade Ave, Sisters, OR 97759-5014 | 2020-09-25 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1548870306 | Virtual Recovery | Nurse Practitioner | 1038 Heathrow Dr, Eugene, OR 97402-1585 | 2020-08-06 |
| 1174148969 | Martina D Ford | Nurse Practitioner | 9370 Sw Greenburg Rd Ste 200, Tigard, OR 97223-5421 | 2020-06-08 |
| 1134740152 | South Coast Healthcare LLC | Nurse Practitioner | 29641 Ellensburg Ave, Gold Beach, OR 97444-8701 | 2020-04-30 |
| 1124657887 | Shelly Prather | Nurse Practitioner | 350 Wheeler St, Lebanon, OR 97355-4349 | 2020-04-05 |
| 1811521586 | Valorine Tsopmoh Tsopmoh | Nurse Practitioner | 924 Se Sacha Pl, Hillsboro, OR 97123-4685 | 2020-03-02 |
| 1174163356 | Erika Nichole Adams | Nurse Practitioner | 180 Ford Rd., John Day, OR 97845 | 2020-01-15 |
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| Find all providers with the same taxonomy | ||||
| City | SILVER LAKE |
| Zip Code | 97638 |
Please comment or provide details below to improve the information on PATRICIA DIANE WIDENOJA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.