Individual
MRS. SHARLYN JO TIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
106 NORTH 4TH AVE, FERGUS FALLS, MN 56537-1034
(218) 998-3778
(218) 998-3187
Mailing address
PO BOX 162, 1448 160TH ST, LAKE BENTON, MN 56149
(507) 368-4274
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0521275
MN
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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