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General NPI Number Information
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NPI Number | 1265681589
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Entity Type | Organization
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Legal Business Name | MMCS LLC KATHRYN GELO SOLE MBR
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 10401 CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89135-1151
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Country | US
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Telephone | 702-497-9706
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Fax | 702-965-2544
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Provider Business Mailing Address
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Address Line | PO BOX 34171
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City | LAS VEGAS
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State | NV
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Zip | 89133-4171
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Country | US
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Telephone | 702-497-9706
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Fax | 702-965-2544
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Authorized Official
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Title or Position | OWNER
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Name | KATHRYN GELO
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Credential | APN
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Telephone | 702-497-9706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN00362
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License Number State | NV
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