MEDICARE: SEAN AVERY TELMO RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	886647	NV

General Provider Information

NPI Number	:	1588592877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN AVERY TELMO RN

Provider Business Mailing Address
First Line	:	7377 AQUIFER ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-5444
Country	:	US
Telephone Number	:	702-405-9596
Fax Number	:

Provider Business Practice Location Address
First Line	:	3087 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3754
Country	:	US
Telephone Number	:	702-405-9596
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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