Healthcare Provider Details

I. General information

NPI: 1083169270
Provider Name (Legal Business Name): DAWN ELIZABETH TINGWALD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 02/13/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W WALNUT ST
OGDEN IA
50212-3060
US

IV. Provider business mailing address

603 W STATE ST
JEFFERSON IA
50129-1723
US

V. Phone/Fax

Practice location:
  • Phone: 515-275-2417
  • Fax: 515-275-4678
Mailing address:
  • Phone: 515-370-4935
  • Fax: 515-386-4935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG183079
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA111268
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: