Provider Demographics
NPI:1639438914
Name:KEBEDE, SHEBIRE
Entity Type:Individual
Prefix:
First Name:SHEBIRE
Middle Name:
Last Name:KEBEDE
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 1:1707 L ST, NW 900
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036
Mailing Address - Country:US
Mailing Address - Phone:202-829-1111
Mailing Address - Fax:202-783-7583
Practice Address - Street 1:1707 L ST, NW 900
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-829-1111
Practice Address - Fax:202-783-7583
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide