Individual
CHAD TIADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
8200 DODGE ST, OMAHA, NE 68114-4113
(402) 955-5142
Mailing address
8200 DODGE ST, OMAHA, NE 68114-4113
(402) 955-5142
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3127
OK
Other
Enumeration date
12/06/2019
Last updated
04/08/2022
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