Aeden Ghebreselassie, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11032157 Issued in FL

Practice address

2001 County Road 210 W Ste 200
St Johns, FL 32259-1181

Phone

(904) 450-8120

Fax

(904) 230-1066

NPI assigned

Dec 17, 2012

Last updated

Oct 20, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premise Health of Virginia Medical PC

  dba Be Well Health Center Tysons

  • Urgent Care Clinic/Center
  • McLean, VA
  • NPI 1992148241
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792454400000",
    "number": "1093051237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COUNTY ROAD 210 W STE 200",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591181",
            "telephone_number": "904-450-8120",
            "fax_number": "904-230-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 COUNTY ROAD 210 W STE 200",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591181",
            "telephone_number": "904-450-8120",
            "fax_number": "904-230-1066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1680 Capital One Dr",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221023407",
            "country_code": "US",
            "telephone_number": "703-720-1290",
            "fax_number": "703-720-1291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHEBRESELASSIE",
        "first_name": "AEDEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11032157",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Peter Garske
• Angelina Gavel-Rukha, OD
• Melissa Nicole Gebhardt, APRN
• Geneva Preschool Therapy Center
• Gerald H Fisher & Erika L Fisher, PA (Complete Family Eye Care)
• Amanda (Amy) Gibbes, PT
• GNM MD, LLC
• Diana Gorelik, APRN
• Dustin Gorgi, DC
• Stephanie Q. Grant, M.A., CCC-SLP

• Family Nurse Practitioner in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.