Organization · Type 2 NPI

Tidalhealth Physician Network, Inc.

Nurse Practitioner · Seaford, DE

NPI number 1114712692 Active

Practice location

8472 Herring Run Rd Unit A
Seaford, DE 19973-5763

Mailing address

PO Box 824327
Philadelphia, PA 19182-4327

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNone listed

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 1114712692

Tidalhealth Physician Network, Inc.'s National Provider Identifier is 1114712692, issued on Apr 14, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Seaford, DE. The record was last updated on Jul 22, 2025.