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General NPI Number Information
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NPI Number | 1245756907
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Entity Type | Individual
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Provider Name | MEDHIN G GEBREAMLAK NP
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Gender | Male
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 1627 KENILWORTH AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20019-2010
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Country | US
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Telephone | 703-732-7126
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Fax |
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Provider Business Mailing Address
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Address Line | 8072 HORSESHOE COTTAGE CIR
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City | LORTON
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State | VA
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Zip | 22079-2327
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Country | US
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Telephone | 301-477-4916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC002080
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC002080
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1024535
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License Number State | DC
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