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General NPI Number Information
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NPI Number | 1336904242
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Entity Type | Individual
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Provider Name | YESHIMEBET TEGENE
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Gender | Female
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Dates
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Enumeration Date | 02/20/2024
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 2306 ZANE PL
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1651
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Country | US
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Telephone | 720-934-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 1188 S RIFLE CIR
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City | AURORA
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State | CO
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Zip | 80017-4224
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Country | US
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Telephone | 720-934-1065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number | 013230172
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License Number State | CO
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