Individual
ANGELA TISDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 ROSEDALE AVE, THOMASVILLE, GA 31792-6655
(229) 228-6577
Mailing address
2000 LULLWATER RD, ALBANY, GA 31707-3151
(229) 343-8399
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN107183
GA
Other
Enumeration date
12/15/2019
Last updated
12/15/2019
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