Provider Demographics
NPI:1922852367
Name:EZEMINDS LLC
Entity Type:Organization
Organization Name:EZEMINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ZENATSEHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBRETSADIK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-PMH
Authorized Official - Phone:240-535-3120
Mailing Address - Street 1:6218 GEORGIA AVENUE NW
Mailing Address - Street 2:STE 1 - 693
Mailing Address - City:WASHINGTON, D.C
Mailing Address - State:DC
Mailing Address - Zip Code:20011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6218 GEORGIA AVENUE NW
Practice Address - Street 2:STE 1 - 693
Practice Address - City:WASHINGTON, D.C
Practice Address - State:DC
Practice Address - Zip Code:20011
Practice Address - Country:US
Practice Address - Phone:240-535-3120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty