Provider Demographics
NPI:1629602636
Name:BERHE, LIBANOS GIRMAY (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:LIBANOS
Middle Name:GIRMAY
Last Name:BERHE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 PENNSYLVANIA AVE NW FL 7
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-3201
Mailing Address - Country:US
Mailing Address - Phone:202-741-2700
Mailing Address - Fax:202-714-2721
Practice Address - Street 1:2150 PENNSYLVANIA AVE NW FL 7
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-3201
Practice Address - Country:US
Practice Address - Phone:202-741-2700
Practice Address - Fax:202-741-2721
Is Sole Proprietor?:No
Enumeration Date:2020-02-28
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178465363L00000X
DCRN1031739363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner