Dana S Widdison, M.S.N, A.P.N., C.N.M

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

APN00207 Issued in NV

Practice address

700 Shadow Lane
Suite 165-a
Las Vegas, NV 89106

Phone

(702) 522-9640

Fax

(702) 522-9641

NPI assigned

Aug 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife, Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1366720633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SHADOW LANE",
            "address_2": "SUITE 165-A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-522-9640",
            "fax_number": "702-522-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SHADOW LANE",
            "address_2": "SUITE 165-A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89106",
            "telephone_number": "702-522-9640",
            "fax_number": "702-522-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDISON",
        "first_name": "DANA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "M.S.N, A.P.N., C.N.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "RN15770",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NV",
            "license": "APN00207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fusae Mary Wicks, NP
• Patricia Jean Wicks
• Roamon Wicks
• Tina Wicks
• Shindena Widby
• Marcella Wideman
• Anastasia Elisabeth Wied
• Micah Wiedemann
• Bryan Wiederholt, DNAP, CRNA
• Sarah Wiederholt, LMSW

• Advanced Practice Midwife in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Advanced Practice Midwife in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.