Samuel Lawrence Widdowson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0991213-NP Issued in CO

Practice address

3676 Parker Blvd
Pueblo, CO 81008-2212

Phone

(484) 619-1973

NPI assigned

Nov 6, 2013

Sex

Male

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1962831354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "484-619-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "484-619-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDOWSON",
        "first_name": "SAMUEL",
        "middle_name": "LAWRENCE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-06",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013311",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991213-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Gloria Whitton, BS
• Whole Person Psychotherapy
• Nikolos Whybrew
• Mandie Leigh Wiant
• Erik Matthews Wickstrum, CRNA
• William Donald Wierman, MD
• Kori Wilcutt
• Wildform Therapy, PLLC
• Alex Wiley, M.ED
• Brandon Wiley, DPT

• Family Nurse Practitioner in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.