Provider Demographics
NPI:1487274320
Name:MYTELENP PLLC
Entity type:Organization
Organization Name:MYTELENP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:901-237-5598
Mailing Address - Street 1:PO BOX 770577
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38177-0577
Mailing Address - Country:US
Mailing Address - Phone:901-237-5598
Mailing Address - Fax:901-328-5670
Practice Address - Street 1:1902 CLARINGTON DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1939
Practice Address - Country:US
Practice Address - Phone:901-609-4422
Practice Address - Fax:901-328-5670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-21
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty