Individual provider · Type 1 NPI

Dana Tidmore, FNP-C

Family Nurse Practitioner · Southaven, MS

NPI number 1467341636 Active

Practice location

3964 Goodman Rd E Ste 128
Southaven, MS 38672-6494

Call (622) 655-0456 Map

Mailing address

3624 Flat Rock Dr
Hernando, MS 38632-4445

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	907549 (MS)

Family Nurse Practitioner: Definition to come...

2 other providers at this address

Mays Medical Wellness, LLCPrimary Care Clinic/Center Southaven, MS NPI 1649790437
Clyde Armstrong Musgrave, DMDPediatric Dentistry Southaven, MS NPI 1194825299

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About NPI 1467341636

Dana Tidmore, FNP-C's National Provider Identifier is 1467341636, issued on Jul 1, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Southaven, MS. The record was last updated on Jul 1, 2025.