EMILY TIDWELL (NPI# 1588691117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588691117 |
| Entity Type | Individual |
| Full Name | EMILY TIDWELL |
| Credential | NP |
| Practice Address |
421 N Broadway Portland TN 37148-1750 |
| Mailing Address |
421 N Broadway Po Box 507 Portland TN 37148-1750 |
| Practice Telephone | 6153231020 |
| Practice Fax Number | 6153231021 |
| Mailing Telephone | 6153231020 |
| Mailing Fax Number | 6153231021 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2012-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
10971 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073990347 | Emily Tidwell | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2015-05-06 |
| Street Address |
421 N BROADWAY |
| City | PORTLAND |
| State | TN |
| Zip Code | 37148-1750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164661674 | Randy Tidwell | Nurse Practitioner | 421 N Broadway, Portland, TN 37148-1750 | 2009-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427608645 | Carehere LLC | Family Medicine | Carehere Clinic- Nasg Portland, Tn, 160 Kirby Drive, Portland, TN 37148 | 2019-09-19 |
| 1710494117 | Lydia Ellen Hicks | Registered Nurse | 214 W. Longview Drive, Portland, TN 37148 | 2018-01-08 |
| 1487903696 | Jennifer Leigh Toney | Registered Nurse | 101 Maurice Ct, Portland, TN 37148 | 2012-09-04 |
| 1366712770 | Pamela Poghen | Registered Nurse | 235 Hwy 52 E, Portland, TN 37148 | 2012-01-03 |
| 1003090036 | State of Tennessee | Public Health or Welfare | 214 West Longview Drive, Portland, TN 37148 | 2007-12-27 |
| 1437256930 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 304 A S Broadway Ste A, Portland, TN 37148 | 2006-09-20 |
| 1568494243 | Melissa R Cook | Nurse Practitioner | 932-b South Broadway, Portland, TN 37148 | 2006-07-06 |
| 1225200306 | Lisa Nazarenus | Nurse Practitioner | 307 S Broadway, Portland, TN 37148 | 2008-03-28 |
| 1770523748 | Jason A Bruns | Physical Therapist | 121 Village Dr, 103, Portland, TN 37148 | 2006-06-07 |
| 1841350196 | Edward Freeman Kirkpatrick Jr. | Dentist | 307 Reed St, Portland, TN 37148-0410 | 2006-12-09 |
| Find all providers in zip 37148 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588136295 | Tao Wang | Nurse Practitioner | 38 Michele Dr, Portland, CT 06480-1013 | 2018-12-19 |
| 1679041115 | Kendra Kathryn Mundstock | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # 13k, Portland, OR 97239-3011 | 2018-11-02 |
| 1043786551 | Lindsey Forleo | Nurse Practitioner | 22 Bramhall St Rm 4670, Portland, ME 04102-3134 | 2018-10-23 |
| 1659801785 | Christine Haboush | Nurse Practitioner | 6015 Ne Skidmore St, Portland, OR 97218-2225 | 2017-06-12 |
| 1386042315 | Jessica Mayer | Nurse Practitioner | 122 Se 80th Ave, Portland, OR 97215-1522 | 2014-12-08 |
| 1376814095 | Paula Claire Havelin | Nurse Practitioner | 235 Highway 52 W, Portland, TN 37148-1407 | 2012-01-26 |
| 1417284175 | Derek Neil Bowers | Nurse Practitioner | 2836 Ne Bryce St, Portland, OR 97212-1640 | 2009-11-17 |
| 1982820692 | Hilary Anne Shreves | Nurse Practitioner | 3303 Sw Bond Ave Ste 10, Portland, OR 97239-4501 | 2007-04-18 |
| 1639174287 | Dawn F. Tilgner | Nurse Practitioner | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2005-06-19 |
| 1225639040 | Lina Rossetti-grulich | Nurse Practitioner | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-11-06 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.