Provider Demographics
NPI:1316827470
Name:WHITLEY, TELA D (MSN, APRN,CNM)
Entity type:Individual
Prefix:
First Name:TELA
Middle Name:D
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:MSN, APRN,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SAN MIGUEL SQ
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-8047
Mailing Address - Country:US
Mailing Address - Phone:432-413-3254
Mailing Address - Fax:432-331-9981
Practice Address - Street 1:401 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4516
Practice Address - Country:US
Practice Address - Phone:432-582-2280
Practice Address - Fax:432-331-9981
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife