Individual
ELIZABETH M TELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
516 DELAWARE ST SE, 5-100 PWB, CLINIC 5B, MINNEAPOLIS, MN 55455-0356
(612) 626-2663
Mailing address
420 DELAWARE ST SE, MMC 480, MINNEAPOLIS, MN 55455-0341
(612) 625-5411
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R 158528
MN
363LA2100X
Acute Care Nurse Practitioner
Primary
R 158528
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139825
UCARE
MN
01
—
398N6BR
BCBS
MN
01
—
B516
TRIWEST
MN
Enumeration date
02/05/2008
Last updated
01/06/2011
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