Healthcare Provider Details

I. General information

NPI: 1598529869
Provider Name (Legal Business Name): KELLY GENE FILBECK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELLY GENE WENTZ RN

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 E FLAMINGO RD STE H
LAS VEGAS NV
89121-5208
US

IV. Provider business mailing address

2950 E FLAMINGO RD STE H
LAS VEGAS NV
89121-5208
US

V. Phone/Fax

Practice location:
  • Phone: 725-251-3854
  • Fax: 725-780-1114
Mailing address:
  • Phone: 725-251-3854
  • Fax: 725-780-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number835512
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: