Individual
PATRICIA TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3919 N MALL AVE, FAYETTEVILLE, AR 72703-4906
(866) 607-7334
Mailing address
3423 W ESSEX DR, FAYETTEVILLE, AR 72704-5376
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A01790
AR
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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