Provider Demographics
NPI:1205621836
Name:ESHETE, HAMERE (FNP)
Entity type:Individual
Prefix:
First Name:HAMERE
Middle Name:
Last Name:ESHETE
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3265 MOSS GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-3851
Mailing Address - Country:US
Mailing Address - Phone:707-501-7464
Mailing Address - Fax:
Practice Address - Street 1:3265 MOSS GLEN CT
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-3851
Practice Address - Country:US
Practice Address - Phone:707-501-7464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF12240368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily