MEDICARE: ELIZABETH G TEGEGNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	HHA200003416	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000001	OTHER	DC	00001
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073179685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH G TEGEGNE

Provider Business Mailing Address
First Line	:	1474 COLUMBIA RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-4773
Country	:	US
Telephone Number	:	202-317-0436
Fax Number	:

Provider Business Practice Location Address
First Line	:	1474 COLUMBIA RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-4773
Country	:	US
Telephone Number	:	202-910-5044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	01/26/2024

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