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NPI Code Detail

MEDICARE: CHRISTINE H. TELLIS FNP-C

MEDICARE: CHRISTINE H. TELLIS FNP-C
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
1363LF0000XFamily Nurse PractitionerNP95000048CA

General Provider Information

NPI Number : 1326442492
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE H. TELLIS FNP-C
Provider Business Mailing Address
First Line : 57675 29 PALMS HWY
Second Line : SUITE 111
City : YUCCA VALLEY
State : CA
Zip : 92284-3098
Country : US
Telephone Number : 760-365-8500
Fax Number : 760-365-8599
Provider Business Practice Location Address
First Line : 66675 PIERSON BLVD
Second Line :
City : DESERT HOT SPRINGS
State : CA
Zip : 92240-3737
Country : US
Telephone Number : 760-676-5240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 05/22/2015

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