Provider Demographics
NPI:1851183503
Name:ASGEDOM, MESGHANE GHIRMAI (APRN)
Entity type:Individual
Prefix:
First Name:MESGHANE
Middle Name:GHIRMAI
Last Name:ASGEDOM
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:702 COFFEE TREE CIR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-6199
Mailing Address - Country:US
Mailing Address - Phone:317-701-7291
Mailing Address - Fax:317-701-7291
Practice Address - Street 1:702 COFFEE TREE CIR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-6199
Practice Address - Country:US
Practice Address - Phone:317-701-7291
Practice Address - Fax:317-701-7291
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71014935A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily