Individual
KAREN REBECCA TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
302 POMONA DR, SUITE L, GREENSBORO, NC 27407-1663
(336) 541-6475
Mailing address
302 POMONA DR, SUITE L, GREENSBORO, NC 27407-1663
(336) 541-6475
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
251259
NC
171M00000X
Case Manager/Care Coordinator
251259
NC
Other
Enumeration date
02/28/2013
Last updated
02/28/2013
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