Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 0024168999 | VA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN66867 | DC |
NPI | 1003117797 |
---|---|
Provider Name | Seble Yirga |
First Address | Washington, DC 20007-2113 |
Second Address | Washington, DC 20007-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2010 |
Last Update Date | 02/11/2011 |