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General NPI Number Information
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NPI Number | 1932347242
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Entity Type | Individual
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Provider Name | PHYLLIS A TELLIS
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Gender | Female
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3030 N TORREY PINES DR
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City | LAS VEGAS
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State | NV
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Zip | 89108-4326
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Country | US
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Telephone | 469-584-0824
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Fax |
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Provider Business Mailing Address
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Address Line | 800 N RAINBOW BLVD STE 218
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City | LAS VEGAS
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State | NV
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Zip | 89107-1189
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Country | US
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Telephone |
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | PRSS-INT-5262
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State | NV
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Taxonomy #5
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number | 0036
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License Number State | NV
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Taxonomy #8
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | CHW2-5120
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License Number State | NV
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