Provider Demographics
NPI:1740702208
Name:GEBRU, ELIZABETH M (HHA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:GEBRU
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 SHERMAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3933
Mailing Address - Country:US
Mailing Address - Phone:202-203-8530
Mailing Address - Fax:
Practice Address - Street 1:2617 SHERMAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3933
Practice Address - Country:US
Practice Address - Phone:202-203-8530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-16
Last Update Date:2017-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide