Provider Demographics
NPI:1770843385
Name:MIYEH, ABONG NASANG (MHNP)
Entity Type:Individual
Prefix:
First Name:ABONG
Middle Name:NASANG
Last Name:MIYEH
Suffix:
Gender:F
Credentials:MHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14729 4TH ST UNIT 228
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4024
Mailing Address - Country:US
Mailing Address - Phone:120-235-2405
Mailing Address - Fax:
Practice Address - Street 1:14729 4TH ST UNIT 228
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4024
Practice Address - Country:US
Practice Address - Phone:120-235-2405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
DCNP1049995363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No374U00000XNursing Service Related ProvidersHome Health Aide