person
Nicole Lynn Tidd
Adult Health Nurse Practitioner in Orangeburg, South Carolina
NPI 1700295284

Nicole Lynn Tidd is an Adult Health Nurse Practitioner based in Orangeburg, SC and is specialized in Adult Health. Nicole Lynn Tidd practices in Orangeburg, SC. The NPI Number for Nicole Lynn Tidd is 1700295284 and holds a License No. 18998 (South Carolina).

The current practice location address for Nicole Lynn Tidd is 1137 Cook Rd, Orangeburg, SC and can be reached out via phone at 803-531-0970 and via fax at 803-395-2237. You can also correspond with Nicole Lynn Tidd through the mailing address at PO BOX 1245, ORANGEBURG, SC - 29116-1245 (mailing address contact number: 803-395-2200).

Location: 1137 Cook Rd, Orangeburg, SC, 29116-1245
person
Provider Profile Details
NPI Number
1700295284
Provider Name
Nicole Lynn Tidd
Credential
Provider Entity Type
Individual
Gender
Female
Address
1137 Cook Rd, Orangeburg, SC, 29116-1245
Phone Number
803-531-0970
Fax Number
803-395-2237
Provider Enumeration Date
08/08/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GP6199 01 SC MEDICAID GROUP NUMBER
institution
Provider Business Practice Location Address Details
Address
1137 Cook Rd
City
State
Zip
29118-8204
Phone Number
803-531-0970
Fax Number
803-395-2237
person
Provider Business Mailing Address Details
Address
1137 Cook Rd
City
State
Zip
29118-8204
Phone Number
803-531-0970
Fax Number
803-395-2237
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
18998 (South Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
18998 (South Carolina)
Definition
Definition to come...
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