MEDICARE: MR. GELVIS CONCEPCION NP

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	363LF0000X	Family Nurse Practitioner	835170	NV
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1588047989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GELVIS CONCEPCION NP

Provider Business Mailing Address
First Line	:	3650 S EASTERN AVE STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3345
Country	:	US
Telephone Number	:	702-333-1009
Fax Number	:	702-342-5428

Provider Business Practice Location Address
First Line	:	3650 S EASTERN AVE STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3345
Country	:	US
Telephone Number	:	702-333-1009
Fax Number	:

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

Provider Enumeration Date	:	07/02/2015
Last Update Date	:	11/20/2025

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