Randy Tidwell, APN | |
421 N Broadway, Portland, TN 37148-1750 | |
(615) 323-1020 | |
(615) 323-1021 |
Full Name | Randy Tidwell |
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Gender | Male |
Speciality | Nurse Practitioner |
Experience | 16 Years |
Location | 421 N Broadway, Portland, Tennessee |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164661674 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 13982 (Tennessee) | Primary |
Entity Name | Tidwell Family Ventures Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518106020 PECOS PAC ID: 2163570474 Enrollment ID: O20090424000314 |
Mailing Address | Practice Location Address |
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Randy Tidwell, APN Po Box 507, 421 N Broadway, Portland, TN 37148-0507 Ph: (615) 323-1020 | Randy Tidwell, APN 421 N Broadway, Portland, TN 37148-1750 Ph: (615) 323-1020 |
Ms. Brandy Nicole Carson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 307 Reed St, Portland, TN 37148 Phone: 615-525-8792 | |
Lisa Nazarenus, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 307 S Broadway, Portland, TN 37148 Phone: 615-325-6755 Fax: 615-325-6936 | |
Ms. Paula Claire Havelin, FNP, ACNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 235 Highway 52 W, Portland, TN 37148 Phone: 615-802-1087 | |
Madeline Mccleary Gillon, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 215 Highland Dr, Portland, TN 37148 Phone: 615-325-9263 | |
Sherelen Hodges, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 235 Highway 52 W, Portland, TN 37148 Phone: 615-802-1087 Fax: 615-802-1088 | |
Mrs. Ashley Jones, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 201 Kirby Dr, Portland, TN 37148 Phone: 615-325-7311 |