Healthcare Provider Details

I. General information

NPI: 1417459603
Provider Name (Legal Business Name): ALEMBEMULU ADANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8228 NEW HAMPSHIRE AVE
SILVER SPRING MD
20903-3423
US

IV. Provider business mailing address

8228 NEW HAMPSHIRE AVE
SILVER SPRING MD
20903-3423
US

V. Phone/Fax

Practice location:
  • Phone: 240-413-6650
  • Fax:
Mailing address:
  • Phone: 240-413-6650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN1039400
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberR185452
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR185253
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP1039400
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: