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General NPI Number Information
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NPI Number | 1699335729
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Entity Type | Individual
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Provider Name | KATHLEEN M TINDALL NP
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 03/19/2022
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Provider Practice Location Address
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Address Line | 550 HARRISON STREET SUITE D
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City | SYRACUSE
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State | NY
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Zip | 13202
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Country | US
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Telephone | 315-464-2160
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Fax | 315-464-2187
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Provider Business Mailing Address
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Address Line | 251 SALINA MEADOWS PARKWAY SUITE 100
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City | SYRACUSE
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State | NY
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Zip | 13212
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Country | US
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Telephone | 315-464-2000
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Fax | 315-464-2010
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 344466
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 344466
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License Number State | NY
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