Provider Demographics
NPI:1497049936
Name:ZEWDIE, FIKERTE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:FIKERTE
Middle Name:
Last Name:ZEWDIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8584 W APPLETON AVE UNIT W
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-4284
Mailing Address - Country:US
Mailing Address - Phone:414-745-1229
Mailing Address - Fax:
Practice Address - Street 1:8584 W APPLETON AVE UNIT W
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-4284
Practice Address - Country:US
Practice Address - Phone:414-745-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI312542-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse