Provider Demographics
NPI:1316783889
Name:TL FAMILY NURSE PRACTICE LLC
Entity type:Organization
Organization Name:TL FAMILY NURSE PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/COFOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEGAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:602-918-3225
Mailing Address - Street 1:3201 W PEORIA AVE STE A105
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4609
Mailing Address - Country:US
Mailing Address - Phone:602-918-3225
Mailing Address - Fax:833-992-2059
Practice Address - Street 1:13055 W MCDOWELL RD STE E101
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6460
Practice Address - Country:US
Practice Address - Phone:602-918-3225
Practice Address - Fax:833-992-2059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TL FAMILY NURSE PRACTICE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty