MEDICARE: MR. BJORN CONCEPCION MAYRINA PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	897204	NV

General Provider Information

NPI Number	:	1710845821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BJORN CONCEPCION MAYRINA PMHNP-BC

Provider Business Mailing Address
First Line	:	10620 SOUTHERN HIGHLANDS PKWY STE 110-231
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4371
Country	:	US
Telephone Number	:	786-801-4111
Fax Number	:

Provider Business Practice Location Address
First Line	:	10620 SOUTHERN HIGHLANDS PKWY STE 110-231
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4371
Country	:	US
Telephone Number	:	786-801-4111
Fax Number	:

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

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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