Provider Demographics
NPI:1689021321
Name:ZELEKE, YESHUMNESH
Entity Type:Individual
Prefix:
First Name:YESHUMNESH
Middle Name:
Last Name:ZELEKE
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 1:1510 ADAMS ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1229
Mailing Address - Country:US
Mailing Address - Phone:202-706-0805
Mailing Address - Fax:
Practice Address - Street 1:1510 ADAMS ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1229
Practice Address - Country:US
Practice Address - Phone:202-706-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCNA00608031376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCNA00608031OtherDISTRICT OF COLUMBIA DEPARTMENT OF HEALTH