Provider Demographics
NPI:1285322966
Name:ULEP, SIMEON VALENTIN BOGACON (FNP-C)
Entity type:Individual
Prefix:
First Name:SIMEON VALENTIN
Middle Name:BOGACON
Last Name:ULEP
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8530 W SUNSET RD STE 310
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2215
Mailing Address - Country:US
Mailing Address - Phone:702-936-8710
Mailing Address - Fax:
Practice Address - Street 1:8530 W SUNSET RD STE 310
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2215
Practice Address - Country:US
Practice Address - Phone:702-936-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV865073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily