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1710623426
ANGELA LYNN TIDEMANN
CANON CITY, CO
NPI
1710623426
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Former Name
ANGELA L. JIMERSON EAVES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CO APN.0997260)
Enumeration Date
2022-05-06
Last Update Date
2023-04-25
Business Address
ANGELA LYNN TIDEMANN FNP
600 EVANS RD
CANON CITY, CO 81212
Phone number: 719-269-5058
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Mailing Address
ANGELA LYNN TIDEMANN FNP
485 VANDERBILT COURT
COLORADO SPRINGS, CO 80906
Phone number: 719-431-3419
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