Provider Demographics
NPI:1700495017
Name:ABEBE, YORDANOS B (FNP)
Entity Type:Individual
Prefix:
First Name:YORDANOS
Middle Name:B
Last Name:ABEBE
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 1:10508 CHESTERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-1672
Mailing Address - Country:US
Mailing Address - Phone:800-452-5574
Mailing Address - Fax:
Practice Address - Street 1:10508 CHESTERWOOD DR
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-1672
Practice Address - Country:US
Practice Address - Phone:800-452-5574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily