Individual ProviderKelly PapeshNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address888 W Bonneville Ave, Las Vegas, NV 89106-0100(702) 483-6000(612) 508-7904PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Papesh is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1386181782Provider TypeIndividualFull NamePapesh, KellyCredentialCNPGenderFemaleSole ProprietorNoEnumeration Date1/23/2017Last Updated1/23/2017Contact InformationPractice LocationPractice Address888 W Bonneville Ave, Las Vegas, NV 89106-0100Phone(702) 483-6000FaxUnlisted FaxMailing LocationMailing Address300 Treehouse Ct, Henderson, NV 89012-2204Phone(612) 508-7904FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN002437Nevada