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General NPI Number Information
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NPI Number | 1285122408
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Entity Type | Individual
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Provider Name | CAROLYN WENDY TELLEZ PMH-NP
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Gender | Female
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 9802 W BELL RD UNIT 1217
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City | SUN CITY
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State | AZ
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Zip | 85372-7010
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Country | US
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Telephone | 520-244-4680
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Fax | 623-666-5795
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Provider Business Mailing Address
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Address Line | 9802 W BELL RD UNIT 1217
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City | SUN CITY
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State | AZ
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Zip | 85372-7010
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Country | US
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Telephone | 520-244-4680
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Fax | 623-666-5795
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN179578
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP11453
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License Number State | AZ
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