Individual
MR. NATHAN TIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP, RN
Contact information
Practice address
205 ORCHARD DR, SISSETON, SD 57262-2312
(605) 698-7647
Mailing address
205 ORCHARD DR, SISSETON, SD 57262-2312
(605) 698-7647
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CP001093
SD
Other
Enumeration date
06/08/2016
Last updated
06/13/2016
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