Individual
LAURA TINDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
COMMUNITY PHYSICIAN NETWORK, HEART AND VASCULAR CARE, 1402 E. COUNTY LINE RD., STE. 2400, INDIANAPOLIS, IN 46227
(317) 621-8500
(317) 621-8501
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7100486A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201217500
—
IN
01
—
P01307607
MEDICARE RR PTAN
IN
Enumeration date
04/03/2014
Last updated
06/14/2021
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