MRS. JERITHEA DORONICE TIDWELL (NPI# 1134387558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134387558 |
Entity Type | Individual |
Full Name | MRS. JERITHEA DORONICE TIDWELL |
Credential | RN PHD, PNP, PCNS |
Practice Address |
1935 Motor Street Children's Medical Center Dallas Dallas TX 75235 |
Mailing Address |
1935 Motor Street Dallas TX 75235 |
Practice Telephone | 2144562331 |
Practice Fax Number | 2144562897 |
Mailing Telephone | 2144562331 |
Mailing Fax Number | 2144562897 |
Enumeration Date | 2008-06-02 |
Last Update Date | 2009-04-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APN0000011923 | TN | Physician Assistants & Advanced Practice Nursing Providers |
Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
659941 | TX | Physician Assistants & Advanced Practice Nursing Providers |
N | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
APN0000011923 | TN | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1935 MOTOR STREET CHILDREN'S MEDICAL CENTER DALLAS |
City | DALLAS |
State | TX |
Zip Code | 75235 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427087535 | Kimberly Lynn Davies | Nurse Practitioner | 1935 Motor Street, Childrens Medical Center, Dallas, TX 75235 | 2006-07-01 |
1538318266 | Kathryn Margaret Johnson | Dietitian, Registered | 1935 Motor Street, Clinical Nutrition, Dallas, TX 75235 | 2008-09-18 |
1891943908 | Elen Petrosyan | Dietitian, Registered | 1935 Motor Street, Dallas, TX 75235-0000 | 2008-09-03 |
1396908018 | Texas Em-1 Medical Services, Pa | Physician Assistant | 1935 Motor Street, Bright Building, Dallas, TX 75235 | 2008-07-02 |
1942477633 | Melissa Perryman | Dietitian, Registered | 1935 Motor Street, Clinical Nutrition, Dallas, TX 75235 | 2008-05-12 |
1700972460 | Glenys S Johnson | Dietitian, Registered | 1935 Motor Street, Clinical Nutrition, Dallas, TX 75235 | 2006-10-04 |
1528150968 | Linda Langford Buckins | Nurse Practitioner | 1935 Motor Street, Pediatric General Surgery, Dallas, TX 75235 | 2006-09-29 |
1013018142 | Fiker Zeray | Registered Nurse | 1935 Motor Street, Children's Medical Center, Dallas, TX 75235 | 2006-09-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265058895 | Kailey Elaine Flowers | Physical Therapy Assistant | 2400 Empire Central Drive, Suite B, Dallas, TX 75235 | 2020-06-19 |
1265061071 | Bella Xinyi O'malley | Student in an Organized Health Care Education/Training Program | 1935 Medical Drive, Dallas, TX 75235 | 2020-04-03 |
1427687318 | Can Ozlu | Student in an Organized Health Care Education/Training Program | Children's Medical Center of Dallas, 1935 Medical Distr, Dallas, TX 75235 | 2020-04-03 |
1689137515 | Tarek Mansi | Student in an Organized Health Care Education/Training Program | 2222 Medical District Dr Apt 4325, Dallas, TX 75235 | 2019-04-08 |
1386117125 | Christine Elizabeth Smith | Physician Assistant | 8134 Tex Oak Avenue, Dallas, TX 75235 | 2019-01-04 |
1447720016 | Michelle Angelina Dye | Physician Assistant | 5959 Maple Avenue Apt 1171, Dallas, TX 75235 | 2018-11-27 |
1255869335 | Andrea Nicole Pennington-peace | Specialist/Technologist, Other | 1935 Medial District, Dallas, TX 75235 | 2017-06-01 |
1194258152 | Tricia Rood | Student in an Organized Health Care Education/Training Program | 5200 Harry Hines Blvd., Dallas, TX 75235 | 2017-04-06 |
1437690971 | Robin Lee | Counselor | 8915 Hrry Hines Blvd, Dallas, TX 75235 | 2017-03-16 |
1871033746 | Javier Davila-lopez | Counselor | 1545 Mockingbird Lane, Suite 4000, Dallas, TX 75235 | 2017-02-27 |
Find all providers in zip 75235 |
Taxonomy Code | 364SP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831735091 | Diana Lynn Cardwell | Clinical Nurse Specialist | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2019-11-22 |
1508239344 | Rebecca Lynn Brooks | Clinical Nurse Specialist | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2015-11-02 |
1659750537 | Virginia Ruth Young | Clinical Nurse Specialist | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2015-05-25 |
1902203870 | Jodie Lantz | Clinical Nurse Specialist | 1935 Medical District Dr, D3.01, Dallas, TX 75235-7701 | 2014-11-20 |
1699182840 | Mayra Guadalupe Rodriguez | Clinical Nurse Specialist | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2014-07-21 |
1093136863 | Amy Selimos | Clinical Nurse Specialist | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2013-12-21 |
1538421334 | Nancy Jane Clegg | Clinical Nurse Specialist | 2222 Welborn St, Department of Neurology, Dallas, TX 75219-3924 | 2012-06-08 |
1700148509 | Susan Ruth Leibold | Clinical Nurse Specialist | 2222 Welborn St, 4th Floor, Dallas, TX 75219-3924 | 2012-06-08 |
1316204118 | Karie Falder | Clinical Nurse Specialist | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2012-04-18 |
1528360039 | Tracy B Chamblee | Clinical Nurse Specialist | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2010-12-03 |
Find all providers in DALLAS |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.