DR. MATTHEW CHARLES WIDEMAN DNP RN AGNP-C NPI 1871112904

NPI Information

  • NPI: 1871112904
  • Provider Name: DR. MATTHEW CHARLES WIDEMAN, DNP, RN, AGNP-C
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • Address: 1727 W BLUEWATER HWY
    IONIA, MI
    ZIP 48846
  • Phone: (616) 527-2510

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NPI Details

DR. Matthew Charles Wideman, DNP, RN, AGNP-C is a nurse practitioner in Ionia, MI. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. DR. Matthew Charles Wideman, DNP, RN, AGNP-C NPI is 1871112904. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1727 W BLUEWATER HWY
IONIA, MI
ZIP 48846-647
Phone: (616) 527-2510

The enumeration date for this NPI number is 4/9/2020 and was last updated on 4/9/2020.

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
1363L00000XNurse Practitioner4704287664NSA2001OMICHIGANYes

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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