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General NPI Number Information
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NPI Number | 1467918268
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Entity Type | Individual
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Provider Name | THEODORE O TINDALL MSN, FNP, NP-C, CFRN
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Gender | Male
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Dates
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Enumeration Date | 02/16/2019
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Last Update Date | 02/16/2019
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Provider Practice Location Address
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Address Line | 20270 E SMOKY HILL RD
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City | CENTENNIAL
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State | CO
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Zip | 80015-3138
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Country | US
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Telephone | 720-386-0729
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Fax |
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Provider Business Mailing Address
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Address Line | 85 UINTA WAY UNIT 104
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City | DENVER
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State | CO
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Zip | 80230-7170
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Country | US
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Telephone | 303-906-5805
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0993280-NP
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License Number State | CO
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