Provider Demographics
NPI:1144318833
Name:ABEBE, YESHIWORK ABAY (RN)
Entity type:Individual
Prefix:
First Name:YESHIWORK
Middle Name:ABAY
Last Name:ABEBE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 E CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-9420
Mailing Address - Country:US
Mailing Address - Phone:480-835-9692
Mailing Address - Fax:
Practice Address - Street 1:960 N STAPLEY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-5604
Practice Address - Country:US
Practice Address - Phone:480-835-9692
Practice Address - Fax:480-835-5457
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN127795163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse