Individual
MRS. KANISHA LANAE TIEDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOULA
Contact information
Practice address
6 MILE HARTNEY BAY ROAD, CORDOVA, AK 99574-1275
(907) 235-9642
Mailing address
PO BOX 1275, CORDOVA, AK 99574-1275
(907) 235-9642
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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