Individual
DEBRA LYNN TIDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
18601 LINCOLN ST, WHITEHALL, WI 54773-8605
(715) 538-4361
(715) 538-2912
Mailing address
1251 E WILSON AVE, ARCADIA, WI 54612-1830
(608) 323-7005
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2950-33
WI
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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