DOUGLAS TIDWELL MSN ARNP FNP-C NPI 1689079337

NPI Information

NPI: 1689079337
Provider Name: DOUGLAS TIDWELL, MSN, ARNP, FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: CONNEXIS MEDICAL SERVICES LLC

PECOS Registration: Yes

Address:
5955 RAND BLVD
SARASOTA, FL
ZIP 34238
Phone: (941) 552-7508
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Douglas Tidwell, MSN, ARNP, FNP-C is a family nurse practitioner in Sarasota, FL with 10 years of experience. Douglas Tidwell, MSN, ARNP, FNP-C NPI is 1689079337. 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:

5955 RAND BLVD
SARASOTA, FL
ZIP 34238-160
Phone: (941) 552-7508
Fax: (941) 552-7605

The NPI 1689079337 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 10/23/2014 and was last updated on 11/20/2019.

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	363LF0000X	Nurse Practitioner	Family	APRN9326689	FLORIDA	No
2	363LF0000X	Nurse Practitioner	Family	9326689	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IB924Z	OTHER	FLORIDA	MEDICARE

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: 11/14/2023

NPI Synchronization or Removal

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