Provider Demographics
NPI:1699399444
Name:GEBERMICHAEL, GENET
Entity Type:Individual
Prefix:
First Name:GENET
Middle Name:
Last Name:GEBERMICHAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 14TH ST NW APT 206
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4570
Mailing Address - Country:US
Mailing Address - Phone:202-446-8684
Mailing Address - Fax:
Practice Address - Street 1:2001 15TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-5828
Practice Address - Country:US
Practice Address - Phone:202-446-8684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant