ANGELA LYNN TIDEMANN FNP
NPI 1710623426
Nurse Practitioner - Family in Canon City, CO

Q: What is Angela Tidemann's NPI number?

The NPI number for Angela Tidemann is 1710623426. It was assigned to this individual provider in the NPPES registry on May 6, 2022. The provider is also known as Angela L. Jimerson Eaves Fnp.

Q: What is Angela Tidemann'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 Angela Tidemann was last updated on April 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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 May 06, 2022

600 EVANS RD, CANON CITY, CO 81212(719) 269-5058 Get Directions Write a Review

NPPES record last updated: April 25, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Angela Lynn Tidemann Fnp NPPES

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

ANGELA LYNN TIDEMANN FNP (NPI 1710623426) is an individual family provider in Canon City, Colorado, licensed in Colorado (APN.0997260) and active in the NPI registry since May 2022.

NPPES Registry Identity

NPI1710623426

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameANGELA LYNN TIDEMANNCredential: FNP

Location Address600 EVANS RDCanon City, CO 81212

Mailing Address485 Vanderbilt CourtColorado Springs, CO 80906 · (719) 431-3419

Phone(719) 269-5058

Sole ProprietorYes

Enumeration DateMay 6, 2022

Last NPPES UpdateApril 25, 2023

NPPES CertifiedApril 25, 2023

✔ NPI 1710623426 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 CO · APN.0997260

600 EVANS RD, Canon City, CO 81212

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Other Names 1

Former Name (1)Angela L. Jimerson Eaves Fnp

Other Providers at the Same Location NPPES 3

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

STEFFANIE LYNN ONTIVEROS FNP

Nurse Practitioner (Family)

600 EVANS RD
CANON CITY, CO 81212

Fremont County (719) 269-5080

LONNIE MCCARRON LCSW

Social Worker (Clinical)

600 EVANS RD, FREMONT CORRECTIONAL FACILITY
CANON CITY, CO 81212

Fremont County (719) 269-5100

JOVANKA MEDINA MSW,LSW

Social Worker

600 EVANS RD
CANON CITY, CO 81212

Fremont County (719) 267-5757

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 Angela Tidemann's NPI number?

The NPI number for Angela Tidemann is 1710623426. It was assigned to this individual provider in the NPPES registry on May 6, 2022. The provider is also known as Angela L. Jimerson Eaves Fnp.

Where is Angela Tidemann located?

Angela Tidemann practices at 600 Evans Rd, Canon City, CO 81212. The listed phone number is (719) 269-5058.

What is Angela Tidemann'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 Angela Tidemann was last updated on April 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.