Provider Demographics
NPI:1306276589
Name:GEDAFIE, TEWABECH GETNET (CRNP)
Entity type:Individual
Prefix:
First Name:TEWABECH
Middle Name:GETNET
Last Name:GEDAFIE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBRITU
Other - Middle Name:GETNET
Other - Last Name:GEDAFIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15505 PENNYROYAL LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1470
Mailing Address - Country:US
Mailing Address - Phone:615-579-8142
Mailing Address - Fax:
Practice Address - Street 1:3110 OLNEY SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1408
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR178235363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily