Individual
ELESHA P TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
532 S CHURCH ST, TUPELO, MS 38804-4708
(662) 841-9015
Mailing address
1793 CLIFF GOOKIN BLVD, TUPELO, MS 38801-6723
(662) 842-1161
(662) 842-6375
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R866110
MS
Other
Enumeration date
11/02/2010
Last updated
03/04/2026
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