Healthcare Provider Details

I. General information

NPI: 1588047989
Provider Name (Legal Business Name): GELVIS CONCEPCION NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 S EASTERN AVE STE 300
LAS VEGAS NV
89169-3345
US

IV. Provider business mailing address

3650 S EASTERN AVE STE 300
LAS VEGAS NV
89169-3345
US

V. Phone/Fax

Practice location:
  • Phone: 702-333-1009
  • Fax:
Mailing address:
  • Phone: 702-333-1009
  • Fax: 702-342-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number835170
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number835170
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: