Provider Demographics
NPI:1972890283
Name:LANSDELL, TAWNYA LEE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:TAWNYA
Middle Name:LEE
Last Name:LANSDELL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E COLLIN RAYE DR
Mailing Address - Street 2:
Mailing Address - City:DE QUEEN
Mailing Address - State:AR
Mailing Address - Zip Code:71832-8048
Mailing Address - Country:US
Mailing Address - Phone:870-584-1053
Mailing Address - Fax:870-584-2084
Practice Address - Street 1:500 E COLLIN RAYE DR
Practice Address - Street 2:
Practice Address - City:DE QUEEN
Practice Address - State:AR
Practice Address - Zip Code:71832-8048
Practice Address - Country:US
Practice Address - Phone:870-642-7257
Practice Address - Fax:870-642-5015
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1766363LF0000X
OK87408363LF0000X
ARA003557363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5AH02OtherBCBS
AR195195758Medicaid
AR262448ZRH3Medicare PIN