Provider Demographics
NPI:1275057531
Name:YOHANNES, NESANETTE BIRRE (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:NESANETTE
Middle Name:BIRRE
Last Name:YOHANNES
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8221 WILLOW OAKS CORPORATE DR STE 4-420
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4512
Practice Address - Country:US
Practice Address - Phone:703-289-7560
Practice Address - Fax:703-204-9001
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY402284363LP0808X
VA0024175165363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health