Healthcare Provider Details

I. General information

NPI: 1235482787
Provider Name (Legal Business Name): MEKEYA M YIMAN HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2012
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 1ST ST NW
WASHINGTON DC
20001-1403
US

IV. Provider business mailing address

901 1ST ST NW
WASHINGTON DC
20001-1403
US

V. Phone/Fax

Practice location:
  • Phone: 202-282-3004
  • Fax: 202-282-2057
Mailing address:
  • Phone: 202-282-3004
  • Fax: 202-282-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00192890
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: