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General NPI Number Information
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NPI Number | 1134713159
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Entity Type | Organization
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Legal Business Name | MIND & BODY WELLNESS, PLLC
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 329 SILVER GROVE CHURCH RD
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City | ROCKINGHAM
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State | NC
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Zip | 28379-6978
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Country | US
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Telephone | 910-387-3840
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Fax | 704-703-9668
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Provider Business Mailing Address
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Address Line | 329 SILVER GROVE CHURCH RD
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City | ROCKINGHAM
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State | NC
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Zip | 28379-6978
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Country | US
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Telephone | 704-476-9144
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEISTEY TINDALL
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Credential | PMHNP, FNP
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Telephone | 704-476-9144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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