Provider Demographics
NPI:1295590263
Name:ABEBE, HANNY YOHANNES
Entity type:Individual
Prefix:
First Name:HANNY
Middle Name:YOHANNES
Last Name:ABEBE
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 1:2175 N ACADEMY CIR SUIT 8
Mailing Address - Street 2:24518 E LOUISIANA CIR. AURORA CO 80018
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1682
Mailing Address - Country:US
Mailing Address - Phone:720-481-1624
Mailing Address - Fax:
Practice Address - Street 1:2175 N ACADEMY CIR SUIT 8
Practice Address - Street 2:24518 E LOUISIANA CIR. AURORA CO 80018
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1682
Practice Address - Country:US
Practice Address - Phone:720-481-1624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO93-1994056343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)