Provider Demographics
NPI:1871119156
Name:TELLERS, ASHLYN
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:TELLERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 E BUTHERUS DR STE 9
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2523
Mailing Address - Country:US
Mailing Address - Phone:602-377-7326
Mailing Address - Fax:
Practice Address - Street 1:8160 E BUTHERUS DR STE 9
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2523
Practice Address - Country:US
Practice Address - Phone:602-377-7326
Practice Address - Fax:480-499-5526
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ242212363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health