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General NPI Number Information
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NPI Number | 1992561500
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Entity Type | Organization
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Legal Business Name | TLC HEALTH SERVICES LLC
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1225 HANCOCK RD BLDG C, STE 302
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-5948
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Country | US
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Telephone | 928-440-6995
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Fax | 928-404-9175
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Provider Business Mailing Address
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Address Line | 1225 HANCOCK RD BLDG C, STE 302
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-5948
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Country | US
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Telephone | 928-440-6995
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Fax | 928-404-9175
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Authorized Official
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Title or Position | APRN,FNP-C/PROVIDER/OWNER
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Name | MRS. JOIE LYNN TEDDER
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Credential | APRN,FNP-C
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Telephone | 620-660-5770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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