Healthcare Provider Details

I. General information

NPI: 1942023015
Provider Name (Legal Business Name): LENA MARGARET TINDALL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 BEAVER RUN BLVD UNIT D
MYRTLE BEACH SC
29575-5392
US

IV. Provider business mailing address

555 E CHEVES ST
FLORENCE SC
29506-2617
US

V. Phone/Fax

Practice location:
  • Phone: 843-650-1085
  • Fax:
Mailing address:
  • Phone: 843-777-2000
  • Fax: 843-777-5465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number322214
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number267999
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: