Provider Demographics
NPI:1568036382
Name:GHONEIM, KERNIBA YOHI (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KERNIBA
Middle Name:YOHI
Last Name:GHONEIM
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 MINE RD STE 2-182
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7556
Mailing Address - Country:US
Mailing Address - Phone:240-472-4354
Mailing Address - Fax:
Practice Address - Street 1:18831 SUMMER OAK CT
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1944
Practice Address - Country:US
Practice Address - Phone:124-047-2435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR181718163W00000X
VA0001299497163W00000X
DCRN1012847163W00000X
MDAC003755363LP0808X
DCNP1012847363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty