Tidwell, Shari P

Tidwell, Shari P is an individual health care provider with primary practice located at 1445 Parr Ave , Dyersburg TN 38024-3153. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tidwell, Shari P can be contacted via phone (731) 286-6156.

Contact Information

Primary practice address
1445 Parr Ave Dyersburg TN 38024-3153
Phone: (731) 286-6156
Fax: (731) 286-6797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 6331 Tennessee

Profile Details

NPI number 1912906421
LBN Legal business name Tidwell, Shari P
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Nov 2nd, 2016 - about 8 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 1912906421 NPPES
Other 3120511 BCBS OF TN
MEDICAID 3902167 BCBS OF TN

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