| Doctor Name: | CARA JOY TIEDEKEN |
| NPI Number: | 1225307630 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP, RN |
| License Number: | SP012812 |
| Business Practice Address: | 2297 Cape Horn Road Red Lion, PA - 17356 |
| Business Phone Number: | 7172468917 |
| Business Fax Number: | 7172463318 |
| Mailing Address: | 2997 Cape Horn Rd, RED LION |
| State: | PA |
| Postal Code: | 173569327 |
| Phone Number: | 7172468914 |
| Fax Number: | 7172463318 |
| NPI Enumeration Date: | 12/14/2011 |
| NPI Last Update Date: | 02/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | SP012812 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |