Individual
JOLING JULIE TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 948-0726
(317) 274-4491
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
71007798
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71007798A
IN
Other
Enumeration date
02/14/2018
Last updated
12/29/2020
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