Healthcare Provider Details

I. General information

NPI: 1659217883
Provider Name (Legal Business Name): MEDHANIT MEKONNIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1437 SOMERSET PL NW
WASHINGTON DC
20011-1075
US

IV. Provider business mailing address

1437 SOMERSET PL NW
WASHINGTON DC
20011-1075
US

V. Phone/Fax

Practice location:
  • Phone: 202-279-8838
  • Fax:
Mailing address:
  • Phone: 202-279-8838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200006118
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: