Provider Demographics
NPI:1992561500
Name:TLC HEALTH SERVICES LLC
Entity type:Organization
Organization Name:TLC HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN,FNP-C/PROVIDER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TEDDER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN,FNP-C
Authorized Official - Phone:620-660-5770
Mailing Address - Street 1:1225 HANCOCK RD
Mailing Address - Street 2:BLDG C, STE 302
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-5948
Mailing Address - Country:US
Mailing Address - Phone:928-440-6995
Mailing Address - Fax:928-404-9175
Practice Address - Street 1:1225 HANCOCK RD
Practice Address - Street 2:BLDG C, STE 302
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-5948
Practice Address - Country:US
Practice Address - Phone:928-440-6995
Practice Address - Fax:928-404-9175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty