DANA TIDMORE FNP-C
NPI 1467341636
Nurse Practitioner - Family in Southaven, MS

Q: What is Dana Tidmore's NPI number?

The NPI number for Dana Tidmore is 1467341636. It was assigned to this individual provider in the NPPES registry on July 1, 2025.

Q: What is Dana Tidmore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Dana Tidmore was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 01, 2025

3964 GOODMAN RD E STE 128, SOUTHAVEN, MS 38672(622) 655-0456 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dana Tidmore Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DANA TIDMORE FNP-C (NPI 1467341636) is an individual family provider in Southaven, Mississippi, licensed in Mississippi (907549) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1467341636

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDANA TIDMORECredential: FNP-C

Location Address3964 GOODMAN RD E STE 128Southaven, MS 38672-6494

Mailing Address3624 Flat Rock DrHernando, MS 38632-4445

Phone(622) 655-0456

Sole ProprietorNo

Enumeration DateJuly 1, 2025

NPPES CertifiedJuly 1, 2025

✔ NPI 1467341636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · 907549

3964 GOODMAN RD E STE 128, Southaven, MS 38672

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROF. CLYDE ARMSTRONG MUSGRAVE D.M.D.

Dentist (Pediatric Dentistry)

3964 GOODMAN RD E STE 128
SOUTHAVEN, MS 38672

Desoto County (662) 893-7337

MAYS MEDICAL WELLNESS, LLC

Clinic/Center (Primary Care)

3964 GOODMAN RD E STE 128
SOUTHAVEN, MS 38672

Desoto County (662) 655-0456

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dana Tidmore's NPI number?

The NPI number for Dana Tidmore is 1467341636. It was assigned to this individual provider in the NPPES registry on July 1, 2025.

Where is Dana Tidmore located?

Dana Tidmore practices at 3964 Goodman Rd E Ste 128, Southaven, MS 38672. The listed phone number is (622) 655-0456.

What is Dana Tidmore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Dana Tidmore was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.