Provider Demographics
NPI:1801435094
Name:ZEMEDE, MEKURIA
Entity type:Individual
Prefix:
First Name:MEKURIA
Middle Name:
Last Name:ZEMEDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2229
Mailing Address - Country:US
Mailing Address - Phone:651-502-3204
Mailing Address - Fax:
Practice Address - Street 1:2270 FORD PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3337
Practice Address - Country:US
Practice Address - Phone:888-863-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker