Provider Demographics
NPI:1609184894
Name:ZEWOLDI, NEGASH HAILE (NURSE RN)
Entity Type:Individual
Prefix:
First Name:NEGASH
Middle Name:HAILE
Last Name:ZEWOLDI
Suffix:
Gender:M
Credentials:NURSE RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5077 GARDENWAY CT
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230
Mailing Address - Country:US
Mailing Address - Phone:614-948-2879
Mailing Address - Fax:
Practice Address - Street 1:5077 GARDENWAY CT
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-4063
Practice Address - Country:US
Practice Address - Phone:614-948-2879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH345299163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse