# GRAND WEST FAMILY PRACTICE AND WELLNESS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** GRAND WEST FAMILY PRACTICE AND WELLNESS LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740055599
- **Authorized official:** SHELLY TELLMAN FNP-C (OWNER/MANAGER)
- **Authorized official phone:** (623) 824-5017

## Contact information

- **Practice address:** 13000 N 103RD AVE STE 77, SUN CITY, AZ 85351-3057
- **Practice address phone:** (480) 284-5650
- **Practice address fax:** (480) 284-6431
- **Mailing address:** 13000 N 103RD AVE STE 77, SUN CITY, AZ 85351-3057
- **Mailing address phone:** (480) 284-5650
- **Mailing address fax:** (480) 284-6431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2023
- **Last updated:** 02/06/2024