Provider Demographics
NPI:1083169270
Name:TINGWALD, DAWN ELIZABETH (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ELIZABETH
Last Name:TINGWALD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:IA
Mailing Address - Zip Code:50129-1723
Mailing Address - Country:US
Mailing Address - Phone:515-370-4935
Mailing Address - Fax:515-386-4935
Practice Address - Street 1:320 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:IA
Practice Address - Zip Code:50212-3060
Practice Address - Country:US
Practice Address - Phone:515-275-2417
Practice Address - Fax:515-275-4678
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA111268363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily