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Contact Information

REBEKAH J TISDALE, FNP-BC
4 MONTGOMERY HEIGHTS
WADDINGTON, NY13694
 Phone: 315-388-7872
 Fax: 315-388-4311
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for REBEKAH J TISDALE · (Female)

NPI # 1295566388
Status Active
Credentials FNP-BC (Family Nurse Practitioner)
Entity Individual
Enumeration date 08/09/2024
Last updated 11/27/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 354223
Hospital affiliation(s) Not Available
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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