Healthcare Provider Details

I. General information

NPI: 1649870627
Provider Name (Legal Business Name): ANITA L TYNDALL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28467 DUPONT BLVD UNIT 6
MILLSBORO DE
19966-3749
US

IV. Provider business mailing address

28467 DUPONT BLVD UNIT 6
MILLSBORO DE
19966-3749
US

V. Phone/Fax

Practice location:
  • Phone: 302-272-9738
  • Fax:
Mailing address:
  • Phone: 302-841-4728
  • Fax: 866-371-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0011513
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: