MR. JUSTIN TIDWELL N.P. NPI 1245648922

NPI Information

NPI: 1245648922
Provider Name: MR. JUSTIN TIDWELL, N.P.
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
2333 BUCHANAN ST
SAN FRANCISCO, CA
ZIP 94115
Phone: (415) 600-6000
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MR. Justin Tidwell, N.P. is an acute care nurse practitioner in San Francisco, CA with 11 years of experience. MR. Justin Tidwell, N.P. NPI is 1245648922. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2333 BUCHANAN ST
SAN FRANCISCO, CA
ZIP 94115-925
Phone: (415) 600-6000

The NPI 1245648922 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/26/2014 and was last updated on 6/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	95000691	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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