Provider Demographics
NPI:1891349353
Name:JENFESSA, NATENAEL TESHOME (RN)
Entity type:Individual
Prefix:
First Name:NATENAEL
Middle Name:TESHOME
Last Name:JENFESSA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 KINGMAN PL NW APT#7
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005
Mailing Address - Country:US
Mailing Address - Phone:202-386-2397
Mailing Address - Fax:
Practice Address - Street 1:1504 KINGMAN PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005
Practice Address - Country:US
Practice Address - Phone:202-386-2397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1025311163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse