JOANNA WENAS WIDJAJA DC NPI 1639909682

NPI Information

  • NPI: 1639909682
  • Provider Name: JOANNA WENAS WIDJAJA, DC
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Individual
  • Address: 204 1ST ST STE 111
    SERGEANT BLUFF, IA
    ZIP 51054
  • Phone: (712) 301-7537

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NPI Details

Joanna Wenas Widjaja, DC is a chiropractor in Sergeant Bluff, IA with 3 years of experience. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. Joanna Wenas Widjaja, DC NPI is 1639909682. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: NORTHWESTERN COLLEGE OF CHIROPRACTIC
Graduation Year:2023

The provider's business location address is:

204 1ST ST STE 111
SERGEANT BLUFF, IA
ZIP 51054-532
Phone: (712) 301-7537

The enumeration date for this NPI number is 8/5/2024 and was last updated on 9/20/2024.

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
1111N00000XChiropractor125921IOWAYes

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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