Healthcare Provider Details

I. General information

NPI: 1972311520
Provider Name (Legal Business Name): MRS. HANNA ATSBEHA GEBREEGZIHABER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 E WEST HWY
SILVER SPRING MD
20910-3054
US

IV. Provider business mailing address

1703 E WEST HWY APT 517
SILVER SPRING MD
20910-3074
US

V. Phone/Fax

Practice location:
  • Phone: 571-866-7955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number200004302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: