Individual
KRISTIN TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
1008 W TAFT AVE, SAPULPA, OK 74066-8720
(918) 347-8090
Mailing address
10488 S 86TH EAST AVE, TULSA, OK 74133-7084
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0111034
OK
Other
Enumeration date
07/31/2021
Last updated
07/31/2021
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