Provider Demographics
NPI:1659007367
Name:EJIGU, MESERET GETACHEW (NP)
Entity Type:Individual
Prefix:
First Name:MESERET
Middle Name:GETACHEW
Last Name:EJIGU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 SIMPSON MILL WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5584
Mailing Address - Country:US
Mailing Address - Phone:206-383-9425
Mailing Address - Fax:
Practice Address - Street 1:1011 CARE WAY STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8439
Practice Address - Country:US
Practice Address - Phone:855-739-9953
Practice Address - Fax:877-916-0801
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024184190363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care