JOHNATHAN TIDWELL

BIRMINGHAM, AL
NPI1063870608
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: AL  1-124189)
Enumeration Date2016-02-09
Last Update Date2024-02-01
Business Address
JOHNATHAN TIDWELL CRNP
619 19TH ST S P915
BIRMINGHAM, AL 35233-1900
Phone number: 205-975-0512
Mailing Address
JOHNATHAN TIDWELL CRNP
PO BOX 55310
BIRMINGHAM, AL 35255-5310
Phone number: 205-731-9701
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