MRS. JERITHEA DORONICE TIDWELL


Address: 1935 Motor Street, Children's Medical Center Dallas, Dallas, TX 75235
Phone: 2144562331

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 1935 MOTOR STREET
CHILDREN'S MEDICAL CENTER DALLAS
City DALLAS
State TX
Zip Code 75235

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 364SP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City DALLAS
Zip Code 75235

Improve Information

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Dataset Information

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.

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