Individual
MRS. BRENDA LOUISE TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1025 N DOUTY ST, HANFORD, CA 93230-3722
(559) 583-2254
(559) 583-2291
Mailing address
17026 IDAHO AVE, LEMOORE, CA 93245-9112
(559) 583-2254
(559) 583-2291
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10740
CA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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