National Provider Identifier Database

SHELLY D TIDWELL, REGISTERED NURSE – NPI #1942193677
Rehabilitation


Contact Information

SHELLY D TIDWELL, REGISTERED NURSE
1011 HONOR HEIGHTS DR
MUSKOGEE, OK74401-1318
Phone: 918-577-4015
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation 163WR0400X

* Indicates primary specialty

NPI Profile & details for SHELLY D TIDWELL

NPI Number 1942193677
Credentials REGISTERED NURSE
Entity Individual
Enumeration date 06/02/2025
Last updated 06/02/2025 - More than a year ago
Sole proprietor1 Yes
Identifiers
  • OK License #: R0107941
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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