Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Katherine Elizabeth Tidwell, FNP

Individual provider Family Nurse Practitioner · NPI 1972230563

Katherine Elizabeth Tidwell, FNP is a Nurse Practitioner in Jamestown, New York. Qualified in 2022, 4 years ago. Practices with Great Lakes Physician Practice PC, a 143-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

15 S Main St Ste 150
Jamestown, NY 14701-6627
Phone: (727) 519-3447
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 350034 (NY)

Record details

NPI number1972230563
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 3, 2022
Last updated in NPPESAugust 3, 2022
Certification dateAugust 3, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Great Lakes Physician Practice Pc — 143 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Jamestown