Individual
FRANKIE TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1748
(423) 282-9011
Mailing address
226 DE LEE DR, KINGSPORT, TN 37663-2611
(423) 817-5512
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
27671
TN
Other
Enumeration date
06/12/2020
Last updated
06/12/2020
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