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General NPI Number Information
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NPI Number | 1417423948
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Entity Type | Individual
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Provider Name | LAURA E TYNDALL
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Gender | Female
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1492 S MILL AVE STE 206
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City | TEMPE
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State | AZ
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Zip | 85281-5664
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Country | US
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Telephone | 623-288-3656
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Fax |
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Provider Business Mailing Address
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Address Line | 402 W LINCOLN ST APT 361
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City | PHOENIX
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State | AZ
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Zip | 85003-2174
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Country | US
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Telephone | 480-662-2409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 248828
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-19309
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 248828
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License Number State | AZ
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