Provider Demographics
NPI:1265755276
Name:HAILE, TAMENE (RN)
Entity type:Individual
Prefix:MR
First Name:TAMENE
Middle Name:
Last Name:HAILE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4059 ANTHONY CT S
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2937
Mailing Address - Country:US
Mailing Address - Phone:614-537-3868
Mailing Address - Fax:
Practice Address - Street 1:4059 ANTHONY CT S
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2937
Practice Address - Country:US
Practice Address - Phone:614-537-3868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH328419163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical