Tidman, Lee Ann

Tidman, Lee Ann is an individual health care provider with primary practice located at 101 Riverstone Vis Suite 205, Blue Ridge GA 30513-6648. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Tidman, Lee Ann can be contacted via phone (706) 632-4400.

Contact Information

Primary practice address
101 Riverstone Vis Suite 205 Blue Ridge GA 30513-6648
Phone: (706) 632-4400
Fax: (706) 632-4404
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN043489 Georgia

Profile Details

NPI number 1316947260
LBN Legal business name Tidman, Lee Ann
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated May 9th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316947260 NPPES
Georgia MEDICAID 000498165F

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