Provider Demographics
NPI:1225393796
Name:MEKONNEN, ANCHIALEM
Entity Type:Individual
Prefix:
First Name:ANCHIALEM
Middle Name:
Last Name:MEKONNEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 PEABODY ST NW APT 103
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1872
Mailing Address - Country:US
Mailing Address - Phone:202-375-3360
Mailing Address - Fax:
Practice Address - Street 1:900 5TH ST SE APT 308
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4507
Practice Address - Country:US
Practice Address - Phone:240-694-6402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide