Genesis Y Velasquez

Individual provider Active NPI Family Nurse Practitioner · Eielson Afb, AK

NPI 1134864929 · NPPES record last updated Aug 15, 2025

Key facts

NPI
1134864929
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
XXXXXXX (AZ)
Practice address
2630 Central Ave
Eielson Afb, AK 99702-2301
Phone
(907) 377-6980
NPI assigned
May 5, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
XXXXXXXAZMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X XXXXXXX AZ Yes

Addresses

Primary practice location

2630 Central Ave
Eielson Afb, AK 99702-2301

Mailing address

2630 Central Ave
Eielson Afb, AK 99702-2301
Phone (907) 377-6980

Other providers in Eielson Afb, AK

All providers in Eielson Afb, AK · Family Nurse Practitioner in Alaska

Sources for this page

Verify at the official NPI Registry.