Provider Demographics
NPI:1811032246
Name:HAILEAB, YODIT KAFEL (RN)
Entity Type:Individual
Prefix:MRS
First Name:YODIT
Middle Name:KAFEL
Last Name:HAILEAB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3247 ELEANORS GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797
Mailing Address - Country:US
Mailing Address - Phone:301-526-4092
Mailing Address - Fax:410-489-7996
Practice Address - Street 1:3247 ELEANORS GARDEN WAY
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:MD
Practice Address - Zip Code:21797
Practice Address - Country:US
Practice Address - Phone:301-526-4092
Practice Address - Fax:410-489-7996
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2022-07-21
Deactivation Date:2012-03-21
Deactivation Code:
Reactivation Date:2022-07-21
Provider Licenses
StateLicense IDTaxonomies
MDR172148163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse