Provider Demographics
NPI:1316207731
Name:BAYONG, AKWEN N (LPN)
Entity Type:Individual
Prefix:MS
First Name:AKWEN
Middle Name:N
Last Name:BAYONG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 PLYMOUTH ST
Mailing Address - Street 2:APT # 5
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4053
Mailing Address - Country:US
Mailing Address - Phone:240-551-2266
Mailing Address - Fax:
Practice Address - Street 1:8711 PLYMOUTH ST
Practice Address - Street 2:APT # 5
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4053
Practice Address - Country:US
Practice Address - Phone:240-551-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP491188164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse