Provider Demographics
NPI:1346335213
Name:BEYENE YOSIEF
Entity Type:Organization
Organization Name:BEYENE YOSIEF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MR
Authorized Official - First Name:BEYENE
Authorized Official - Middle Name:LUCUS
Authorized Official - Last Name:YOSIEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-368-7557
Mailing Address - Street 1:2904 HOLM OAK CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-2937
Mailing Address - Country:US
Mailing Address - Phone:757-368-7557
Mailing Address - Fax:
Practice Address - Street 1:844 BATTLEFIELD BLVD N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4802
Practice Address - Country:US
Practice Address - Phone:757-312-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1095144163W00000X
VA0024095144367500000X
36698367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010162548Medicaid
VA010162548Medicaid