MEDICARE: SENAIT GEBREYESUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	54958	NM

General Provider Information

NPI Number	:	1295688877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SENAIT GEBREYESUS

Provider Business Mailing Address
First Line	:	3907 CRYSTAL PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-0613
Country	:	US
Telephone Number	:	412-719-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3907 CRYSTAL PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-0613
Country	:	US
Telephone Number	:	412-719-6500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ SENAIT GEBREYESUS ” Practice Location

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