Healthcare Provider Details

I. General information

NPI: 1184824302
Provider Name (Legal Business Name): KATHRYN GELO MS, APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 10/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 N BUFFALO DR
LAS VEGAS NV
89129-7424
US

IV. Provider business mailing address

PO BOX 34171
LAS VEGAS NV
89133-4171
US

V. Phone/Fax

Practice location:
  • Phone: 702-497-9706
  • Fax: 702-965-2544
Mailing address:
  • Phone: 702-497-9706
  • Fax: 702-965-2544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN00362
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: