NPI | 1730182890 |
---|---|
Former Name | SHEILA D TIDWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP129764) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129764) |
Enumeration Date | 2005-05-23 |
Last Update Date | 2018-05-29 |