Provider Demographics
NPI:1467272534
Name:TELLINGTON, ALEXIS
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:TELLINGTON
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 1:4513 PASSION FLOWER LOOP APT A
Mailing Address - Street 2:APT A
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549
Mailing Address - Country:US
Mailing Address - Phone:254-307-2295
Mailing Address - Fax:413-480-8923
Practice Address - Street 1:4513 PASSION FLOWER LOOP APT A
Practice Address - Street 2:APT A
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549
Practice Address - Country:US
Practice Address - Phone:254-307-2295
Practice Address - Fax:413-480-8923
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health