Provider Demographics
NPI:1851858856
Name:GEBRE, ABENET K
Entity Type:Individual
Prefix:
First Name:ABENET
Middle Name:K
Last Name:GEBRE
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 1:1444 ROCK CREEK FORD RD NW APT 110
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1726
Mailing Address - Country:US
Mailing Address - Phone:240-505-4876
Mailing Address - Fax:
Practice Address - Street 1:1444 ROCK CREEK FORD RD NW APT 110
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1726
Practice Address - Country:US
Practice Address - Phone:240-505-4876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14320374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide