Tiedemann, Dawn

Tiedemann, Dawn is an individual health care provider with primary practice located at 455 Lewis Avenue Suite 220, Meriden CT 06451. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Oncology. Physician Assistants & Advanced Practice Nursing Providers / Oncology is her primary health care specialty. Tiedemann, Dawn can be contacted via phone (203) 238-7747.

Contact Information

Primary practice address
455 Lewis Avenue Suite 220 Meriden CT 06451
Phone: (203) 238-7747
Fax: (203) 686-0282
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 001916 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Oncology 364SX0200X 001916 Connecticut

Profile Details

NPI number 1477592301
LBN Legal business name Tiedemann, Dawn
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Oct 10th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477592301 NPPES
Connecticut MEDICAID 004257433

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