Individual
DENISE M. TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-6974
(757) 953-7685
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-7462
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202206163
VA
183500000X
Pharmacist
8894
SC
183500000X
Pharmacist
PS56037
FL
Other
Enumeration date
10/18/2011
Last updated
06/23/2023
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