Provider Demographics
NPI:1447923495
Name:GIDEY, HAYMANOT TEKIA
Entity type:Individual
Prefix:
First Name:HAYMANOT
Middle Name:TEKIA
Last Name:GIDEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7437 MORRISON DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2455
Mailing Address - Country:US
Mailing Address - Phone:202-361-8979
Mailing Address - Fax:410-946-2010
Practice Address - Street 1:7437 MORRISON DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2455
Practice Address - Country:US
Practice Address - Phone:202-361-8979
Practice Address - Fax:410-946-2010
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCNA20203034376K00000X
DCHHA200002232374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide