Provider Demographics
NPI:1366225252
Name:MINDA, TIGIST NADEW (NA)
Entity type:Individual
Prefix:PROF
First Name:TIGIST
Middle Name:NADEW
Last Name:MINDA
Suffix:
Gender:F
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 12TH ST NW APT 122012TH
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-4304
Mailing Address - Country:US
Mailing Address - Phone:202-640-8171
Mailing Address - Fax:
Practice Address - Street 1:1220 12TH ST NW # P905
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4304
Practice Address - Country:US
Practice Address - Phone:202-640-8171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant