Individual
TINA TEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
(574) 272-9000
Mailing address
1540 TRINITY PL, MISHAWAKA, IN 46545-5006
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28119763A
IN
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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