Provider Demographics
NPI:1427122811
Name:WIDSETH, KRISTI LEA (APRN, CRNA)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LEA
Last Name:WIDSETH
Suffix:
Gender:F
Credentials:APRN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:400 EAST THIRD STREET
Mailing Address - Street 2:ESSENTIA HEALTH DULUTH CLINIC MCL2CRED
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-8364
Mailing Address - Fax:
Practice Address - Street 1:900 HILLIGOSS BOULEVARD SE
Practice Address - Street 2:ESSENTIA HEALTH FOSSTON
Practice Address - City:FOSSTON
Practice Address - State:MN
Practice Address - Zip Code:56542
Practice Address - Country:US
Practice Address - Phone:218-435-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN46041367500000X
MN223367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered