Provider Demographics
NPI:1043853377
Name:TSEGA, YEMESRACH A (RN/BSN)
Entity Type:Individual
Prefix:
First Name:YEMESRACH
Middle Name:A
Last Name:TSEGA
Suffix:
Gender:F
Credentials:RN/BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 CLARIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2201
Mailing Address - Country:US
Mailing Address - Phone:703-989-6806
Mailing Address - Fax:703-991-1190
Practice Address - Street 1:3323 CLARIDGE CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2201
Practice Address - Country:US
Practice Address - Phone:703-989-6806
Practice Address - Fax:703-991-1190
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001255571163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health