MISS TRACEY LORENA TELLO CSFA ST NPI 1417388232

NPI Information

  • NPI: 1417388232
  • Provider Name: MISS TRACEY LORENA TELLO, CSFA, ST
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • Address: 931 MONROE DRIVE NE
    SUITE 102 #641
    ATLANTA, GA
    ZIP 30308
  • Phone: (404) 312-1633

Map and Directions

Get Directions

NPI Details

MISS Tracey Lorena Tello, CSFA, ST is a surgical physician assistant in Atlanta, GA. MISS Tracey Lorena Tello, CSFA, ST NPI is 1417388232. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

931 MONROE DRIVE NE
SUITE 102 #641
ATLANTA, GA
ZIP 30308-132
Phone: (404) 312-1633

The enumeration date for this NPI number is 12/4/2013 and was last updated on 11/28/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical146587GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.