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Individual

LAURA A. TYNDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
975 E. THIRD STREET, CHATTANOOGA, TN 37403-2147
(423) 602-8400
(423) 602-8401
Mailing address
PO BOX 2930, INDIANAPOLIS, IN 46206-2930
(844) 468-9496
(855) 630-1300

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN59978
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10743
TN
367500000X
Certified Registered Nurse Anesthetist
RN142582
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000801908A
GA
05
009930325
AL
01
3109914
BLUE CROSS BLUE SHIELD OF TN
TN
05
3627259
TN
01
430048582
RAILROAD MEDICARE
05
8052324
NC
01
N471843
WELLCARE (GA MEDICAID)
GA
Enumeration date
03/26/2007
Last updated
10/03/2017
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