Individual
NORMA TIEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, AGACNP-BC
Contact information
Practice address
100 UCLA MEDICAL PLZ STE 630, LOS ANGELES, CA 90024-6997
(310) 825-9011
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95001281
CA
363LA2100X
Acute Care Nurse Practitioner
95001281
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
95001281
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295139244
NPI
CA
Enumeration date
10/20/2014
Last updated
05/21/2025
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