MEDICARE: APRIL KELLY GELENTER 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	363L00000X	Nurse Practitioner	NP 13674	CA

General Provider Information

NPI Number	:	1992759484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APRIL KELLY GELENTER NP

Provider Business Mailing Address
First Line	:	99 MONTECILLO RD
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-3308
Country	:	US
Telephone Number	:	415-444-2579
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 MONTECILLO RD
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-3308
Country	:	US
Telephone Number	:	415-444-2579
Fax Number	:

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	01/31/2022

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