Provider Demographics
NPI:1992459689
Name:KONE, DJENEBA
Entity type:Individual
Prefix:
First Name:DJENEBA
Middle Name:
Last Name:KONE
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 1:8201 16TH ST APT 905
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3251
Mailing Address - Country:US
Mailing Address - Phone:443-929-5520
Mailing Address - Fax:
Practice Address - Street 1:8201 16TH ST APT 905
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3251
Practice Address - Country:US
Practice Address - Phone:443-929-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401202394376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide