Healthcare Provider Details

I. General information

NPI: 1083556880
Provider Name (Legal Business Name): MRS. MISRAK M GEBREKIRISTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 14TH ST NW APT 205
WASHINGTON DC
20009-4944
US

IV. Provider business mailing address

1836 METZEROTT RD APT 1501
ADELPHI MD
20783-3450
US

V. Phone/Fax

Practice location:
  • Phone: 703-864-7092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: