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Alyssa Lynn Tidemann

NPI Registration Record

Provider / OrganizationNPIDate Certified
ALYSSA LYNN TIDEMANN12559106832021-04-04

Alyssa Lynn Tidemann is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1255910683. Registration indicates Alyssa Lynn Tidemann is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)

Entity TypeIndividual
Provider Name Alyssa Lynn Tidemann
Practice Office Address8701 W WATERTOWN PLANK RD
MILWAUKEE, WI US
Practice Office Telephone4149554575
Mailing Address8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 532263548 US
HPT Codes
CodePractice
License No
State
390200000X PRIMARY
Student, Health Care
Student in an Organized Health Care Education/Training Program
Student in an Organized Health Care Education/Training Program

All Other Specialties & Provider Types

Student in an Organized Health Care Education/Training Program
Student, Health Care
OPI Codes

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