Provider Demographics
NPI:1760121602
Name:WOLDEANANIYA, ABEBA REDA (CNA)
Entity Type:Individual
Prefix:MRS
First Name:ABEBA
Middle Name:REDA
Last Name:WOLDEANANIYA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 BELVEDERE BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5633
Mailing Address - Country:US
Mailing Address - Phone:301-728-1401
Mailing Address - Fax:
Practice Address - Street 1:2101 BELVEDERE BLVD APT 4
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5633
Practice Address - Country:US
Practice Address - Phone:301-728-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00186502376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide