Brittany Widebrook, PN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2019037646 Issued in MO

Practice address

141 Communication Dr
Hannibal, MO 63401-3670

Phone

(573) 603-1460

Fax

(573) 603-1462

NPI assigned

Dec 16, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Advanced Practice Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1003454570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N 2ND ST STE 200",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012894",
            "telephone_number": "636-224-1210",
            "fax_number": "636-946-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 COMMUNICATION DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013670",
            "telephone_number": "573-603-1460",
            "fax_number": "573-603-1462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDEBROOK",
        "first_name": "BRITTANY",
        "credential": "PN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "2019037646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joni Gayle Wheeler, LPN
• Meghan Rhianne Wheeler
• White Oak Counseling, LLC
• Barbara A White, D.O.
• Kristine Marie Whitehead, MSW, LCSW
• Judy Wilcox
• Sherri M. Wiley
• Tria Wilhite, M.D.
• William J. Esicar, D.M.D., P.C.
• Williams Mark Twain Group Home

• Licensed Practical Nurse in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.