Individual provider · Type 1 NPI

Jessi Blackstock Tidwell, CRNP

Nurse Practitioner · Florence, AL

NPI number 1013556356 Active

Practice location

2904 Mall Rd
Florence, AL 35630-1641

Fax (949) 695-4340

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000X1-162142 (AL)
Psychiatric/Mental Health Nurse Practitioner 363LP0808X1-162142 (AL)
Nurse Practitioner Primary 363L00000X1-162142 (AL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1013556356

Jessi Blackstock Tidwell, CRNP's National Provider Identifier is 1013556356, issued on Jan 3, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Florence, AL. The record was last updated on May 1, 2025.