Active NPI
Lorraine Kay Widdall, CNS
- Medical-Surgical Clinical Nurse Specialist
- Munster, IN
National Provider Identifier
1740230531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Clinical Nurse Specialist
- License
- 28087637A
- Practice address
- 8317 Calumet Ave
Munster, IN 46321-1737 - Phone
- (219) 513-2333
- Fax
- (219) 513-1127
- NPI assigned
- May 11, 2006
- Last updated
- Apr 20, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Clinical Nurse Specialist | 364SM0705X | 28087637A | IN | Primary |
Addresses
Primary practice location
8317 Calumet Ave
Munster, IN 46321-1737
Mailing address
8317 Calumet Ave
Munster, IN 46321-1737
Phone (219) 513-2333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200473170 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28087637A | IN | MD | Medical-Surgical Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1740230531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8317 CALUMET AVE",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463211737",
"telephone_number": "219-513-2333",
"fax_number": "219-513-2334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8317 CALUMET AVE",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463211737",
"telephone_number": "219-513-2333",
"fax_number": "219-513-1127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDDALL",
"first_name": "LORRAINE",
"middle_name": "KAY",
"credential": "CNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-11",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "364SM0705X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Medical-Surgical",
"state": "IN",
"license": "28087637A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200473170",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.