Individual provider · Type 1 NPI

Jennifer Nicole Tisdale, PA-C

Nurse Practitioner · Norfolk, VA

NPI number 1154814697 Active

Practice location

7401 Granby St
Norfolk, VA 23505-3406

Call (757) 388-9925 Map

Fax (757) 965-8519

Other practice locations

  • 7401 Granby St, Norfolk, VA 23505-3406 · (757) 388-9925

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Nurse Practitioner Primary 363L00000X0110006241 (VA)

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…

5 other providers at this address

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About NPI 1154814697

Jennifer Nicole Tisdale, PA-C's National Provider Identifier is 1154814697, issued on Jun 9, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Norfolk, VA. The record was last updated on Oct 3, 2024.