MEDICARE: GENICA FELISE GELSON APRN, FNP-BC

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	363L00000X	Nurse Practitioner	818763	NV

General Provider Information

NPI Number	:	1811456486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENICA FELISE GELSON APRN, FNP-BC

Provider Business Mailing Address
First Line	:	700 E. SILVERADO RANCH BLVD.
Second Line	:	STE. 170
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7518
Country	:	US
Telephone Number	:	702-240-6482
Fax Number	:	702-804-0957

Provider Business Practice Location Address
First Line	:	2839 ST. ROSE PARKWAY
Second Line	:	STE. 160
City	:	HENDERSON
State	:	NV
Zip	:	89052-4849
Country	:	US
Telephone Number	:	702-240-6482
Fax Number	:	702-240-8529

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

Provider Enumeration Date	:	03/13/2019
Last Update Date	:	12/23/2019

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