MRS. KIRSTIN JENNA TIDQUIST PMHNP NPI 1700551918

NPI Information

NPI: 1700551918
Provider Name: MRS. KIRSTIN JENNA TIDQUIST, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
8820 S MERIDIAN ST STE 225
INDIANAPOLIS, IN
ZIP 46217
Phone: (317) 865-6922
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MRS. Kirstin Jenna Tidquist, PMHNP is a psychiatric/mental health nurse practitioner in Indianapolis, IN with 3 years of experience. MRS. Kirstin Jenna Tidquist, PMHNP NPI is 1700551918. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8820 S MERIDIAN ST STE 225
INDIANAPOLIS, IN
ZIP 46217-064
Phone: (317) 865-6922

The NPI 1700551918 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 8/10/2021 and was last updated on 5/30/2023.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	71011436A	INDIANA	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	Q00332599	OTHER	INDIANA	RAILROAD PTAN
2	300055577	MEDICAID	INDIANA
3	264430D16	OTHER	INDIANA	MEDICARE PTAN

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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