Individual
OLIVIA TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9419 W VAN BUREN ST, TOLLESON, AZ 85353-2804
(623) 478-4000
Mailing address
10640 W SONORA ST, TOLLESON, AZ 85353-1164
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP247083
AZ
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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