Individual
ANGELA TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
105 N MAGNOLIA ST, SUMTER, SC 29150-4941
(803) 934-2833
(803) 775-7163
Mailing address
105 N MAGNOLIA ST, SUMTER, SC 29150-4941
(803) 934-2833
(803) 775-7163
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
49775
SC
Other
Enumeration date
04/04/2014
Last updated
04/04/2014
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