Provider Demographics
NPI:1457384620
Name:TECLEMARIAM, ASTER HELEN (FNP)
Entity Type:Individual
Prefix:MS
First Name:ASTER
Middle Name:HELEN
Last Name:TECLEMARIAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14210 TRILLIUM TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2458
Mailing Address - Country:US
Mailing Address - Phone:240-426-1884
Mailing Address - Fax:
Practice Address - Street 1:3720 UPTON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2224
Practice Address - Country:US
Practice Address - Phone:301-346-0832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1005441372500000X, 363LF0000X
MDR168192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC036372500Medicaid
DCRN1005441OtherLICENSURE NUMBER
MDR168192OtherMARYLAND CRNP LICENCE
MD019778A72Medicare PIN
DCQ45685Medicare UPIN
MDR168192OtherMARYLAND CRNP LICENCE
DC017153M63Medicare ID - Type Unspecified
MD082NQ387Medicare PIN