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Individual

PHYLLIS A TELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3030 N TORREY PINES DR, LAS VEGAS, NV 89108-4326
(469) 584-0824
Mailing address
800 N RAINBOW BLVD STE 218, LAS VEGAS, NV 89107-1189

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
Primary
CHW2-5120
NV
175T00000X
Peer Specialist
PRSS-INT-5262
NV
246RP1900X
Phlebotomy Technician
NV
247200000X
Other Technician
251B00000X
Case Management Agency
374J00000X
Doula
0036
NV
374J00000X
Doula

Other

Enumeration date
01/23/2009
Last updated
08/07/2025
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