Individual
HALEY TIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
114 COLLEGE AVE, ASHLAND, VA 23005
(804) 752-8878
Mailing address
114 COLLEGE AVE, ASHLAND, VA 23005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6264
SC
Other
Enumeration date
02/26/2026
Last updated
02/26/2026
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