MEDICARE: KELLY PAPESH CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN002437	NV

General Provider Information

NPI Number	:	1386181782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY PAPESH CNP

Provider Business Mailing Address
First Line	:	27 MESQUITE VILLAGE CIR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-3229
Country	:	US
Telephone Number	:	612-508-7904
Fax Number	:	949-703-8555

Provider Business Practice Location Address
First Line	:	1309 COFFEEN AVE # 1200
Second Line	:
City	:	SHERIDAN
State	:	WY
Zip	:	82801-5777
Country	:	US
Telephone Number	:	702-483-6000
Fax Number	:	949-703-8555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2017
Last Update Date	:	03/13/2026

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Directions to “ KELLY PAPESH CNP” Practice Location

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