Provider Demographics
NPI:1699278143
Name:WOYESA, ABEBA
Entity type:Individual
Prefix:
First Name:ABEBA
Middle Name:
Last Name:WOYESA
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 1:8721 DEBORAH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2875
Mailing Address - Country:US
Mailing Address - Phone:301-332-6827
Mailing Address - Fax:
Practice Address - Street 1:8721 DEBORAH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2875
Practice Address - Country:US
Practice Address - Phone:301-332-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12958374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide