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Individual

DR. MARILYN LORETTA TIDWELL -SHOEMAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
233 WINTON BLOUNT LOOP, MONTGOMERY, AL 36117-3507
(334) 350-5648
Mailing address
233 WINTON BLOUNT LOOP, MONTGOMERY, AL 36117-3507
(334) 239-2622

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95013184
CA

Other

Enumeration date
12/05/2019
Last updated
01/16/2024
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