Provider Demographics
NPI:1265670038
Name:WOLDEHIWOT, GENET HAILE
Entity type:Individual
Prefix:MS
First Name:GENET
Middle Name:HAILE
Last Name:WOLDEHIWOT
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 1:4693 ARBOR LEE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-6119
Mailing Address - Country:US
Mailing Address - Phone:614-836-0237
Mailing Address - Fax:
Practice Address - Street 1:4693 ARBOR LEE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-6119
Practice Address - Country:US
Practice Address - Phone:614-836-0237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-01
Last Update Date:2009-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH298027163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse