Provider Demographics
NPI:1487919015
Name:YASIN, FEKERTE MOHAMED (PCA)
Entity type:Individual
Prefix:MRS
First Name:FEKERTE
Middle Name:MOHAMED
Last Name:YASIN
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:MRS
Other - First Name:HALIMA
Other - Middle Name:MOHAMED
Other - Last Name:YASIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6040 14TH ST NW
Mailing Address - Street 2:APT #116
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011
Mailing Address - Country:US
Mailing Address - Phone:202-290-7586
Mailing Address - Fax:202-293-3480
Practice Address - Street 1:1822 JEFFERSON PLACE 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:202-293-2931
Practice Address - Fax:202-293-3480
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide