Individual
DAWN TIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
455 LEWIS AVENUE, SUITE 220, MERIDEN, CT 06451
(203) 238-7747
(203) 686-0282
Mailing address
19 LUNAR DRIVE, WOODBRIDGE, CT 06525
(203) 389-7504
(203) 389-1666
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
001916
CT
364SX0200X
Oncology Clinical Nurse Specialist
Primary
001916
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004257433
—
CT
Enumeration date
06/06/2006
Last updated
10/10/2011
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