JESSICA KING TIDWELL

TYLER, TX
NPI1629454160
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: TX  AP130723)
Additional Taxonomies363LA2100X Nurse Practitioner, Acute Care
(Licence: LA  AP08445)
Enumeration Date2015-08-06
Last Update Date2018-10-22
Business Address
JESSICA KING TIDWELL AGACNP-BC
703 S FLEISHEL AVE STE 5000
TYLER, TX 75701-2015
Phone number: 903-606-2830
Mailing Address
JESSICA KING TIDWELL AGACNP-BC
1501 KINGS HIGHWAY ATTN: LEISA OGLESBY (MED SCH RM 1-201)
SHREVEPORT, LA 71103-4228
Phone number: 318-675-4881