Provider Demographics
NPI:1629694419
Name:TINDALL, JENNIFER GAYLE (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GAYLE
Last Name:TINDALL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:G
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2900 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4802
Mailing Address - Country:US
Mailing Address - Phone:501-278-2800
Mailing Address - Fax:
Practice Address - Street 1:504 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:AR
Practice Address - Zip Code:72020-9151
Practice Address - Country:US
Practice Address - Phone:501-344-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR125415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty