Individual
FANOS TEKLEAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2512 24TH ST NE, WASHINGTON, DC 20018-2126
(202) 832-8340
(202) 832-8341
Mailing address
5746 COLORADO AVE NW, WASHINGTON, DC 20011-7850
(202) 459-7539
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN1008614
DC
374U00000X
Home Health Aide
Primary
HHA14985
DC
374U00000X
Home Health Aide
—
—
Other
Enumeration date
10/26/2018
Last updated
09/01/2020
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