Provider Demographics
NPI:1992583900
Name:BEYENE, ELSA MELASH
Entity type:Individual
Prefix:
First Name:ELSA
Middle Name:MELASH
Last Name:BEYENE
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 1:3024 IRVELLA PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2410
Mailing Address - Country:US
Mailing Address - Phone:513-309-6780
Mailing Address - Fax:
Practice Address - Street 1:3024 IRVELLA PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2410
Practice Address - Country:US
Practice Address - Phone:513-309-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSM1471213747P1801X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant