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Individual

MRS. NORMA B TIDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NA

Contact information

Practice address
162 SHARP AND PERKINS RD, JACKSBORO, TN 37757-2507
(423) 562-8351
(423) 562-1593
Mailing address
PO BOX 418, 162 SHARP-PERKINS RD., JACKSBORO, TN 37757-0418
(423) 562-8351
(423) 562-1593

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
TN

Other

Enumeration date
03/14/2012
Last updated
03/14/2012
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