Provider Demographics
NPI:1265295372
Name:WENONG, MILIAN
Entity type:Individual
Prefix:
First Name:MILIAN
Middle Name:
Last Name:WENONG
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 1:13502 WATER FOWL WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7093
Mailing Address - Country:US
Mailing Address - Phone:346-247-5363
Mailing Address - Fax:
Practice Address - Street 1:13502 WATER FOWL WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7093
Practice Address - Country:US
Practice Address - Phone:346-247-5363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200003332374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide