Provider Demographics
NPI:1558039297
Name:TINDELL, BRANDIE (APRN)
Entity Type:Individual
Prefix:
First Name:BRANDIE
Middle Name:
Last Name:TINDELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4196 HIGHWAY 62 412 STE A
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-8002
Mailing Address - Country:US
Mailing Address - Phone:870-856-1202
Mailing Address - Fax:870-856-2107
Practice Address - Street 1:1016 N FOURCHE AVE
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:AR
Practice Address - Zip Code:72126-8545
Practice Address - Country:US
Practice Address - Phone:870-856-1202
Practice Address - Fax:870-895-2164
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR216972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily