Provider Demographics
NPI:1053940544
Name:TAFESSE, HANA
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:
Last Name:TAFESSE
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 1:5250 AIR EXPRESS RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23250-2420
Mailing Address - Country:US
Mailing Address - Phone:804-222-3330
Mailing Address - Fax:804-222-3334
Practice Address - Street 1:5250 AIR EXPRESS RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23250-2420
Practice Address - Country:US
Practice Address - Phone:804-222-3330
Practice Address - Fax:804-222-3334
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)