Individual
BLAIR ASHLEY DYER TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 PAGEANT LN, CLARKSVILLE, TN 37040-3854
(931) 648-5747
Mailing address
172 TIMBER DR, DOVER, TN 37058-3624
(731) 697-6120
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000274217
TN
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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