CRYSTAL LYNN WIDEMON APRN NPI 1316838659

NPI Information

  • NPI: 1316838659
  • Provider Name: CRYSTAL LYNN WIDEMON, APRN
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10186 SUMAC RD
    GILMER, TX
    ZIP 75644
  • Phone: (620) 433-0333

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NPI Details

Crystal Lynn Widemon, APRN is a family nurse practitioner in Gilmer, TX with 1 years of experience. Crystal Lynn Widemon, APRN NPI is 1316838659. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10186 SUMAC RD
GILMER, TX
ZIP 75644-880
Phone: (620) 433-0333

The NPI 1316838659 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2025 and was last updated on 7/14/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily1204486TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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