Provider Demographics
NPI:1649870627
Name:TYNDALL, ANITA L (FNP-C)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:L
Last Name:TYNDALL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28467 DUPONT BLVD UNIT 6
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-3749
Mailing Address - Country:US
Mailing Address - Phone:302-841-4728
Mailing Address - Fax:866-371-4672
Practice Address - Street 1:28467 DUPONT BLVD UNIT 6
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-3749
Practice Address - Country:US
Practice Address - Phone:302-272-9738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0011513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily