Provider Demographics
NPI:1831550904
Name:MELIOGE, MARCELINE N
Entity type:Individual
Prefix:
First Name:MARCELINE
Middle Name:N
Last Name:MELIOGE
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 1:13906 CASTLE BLVD
Mailing Address - Street 2:APT 303
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4943
Mailing Address - Country:US
Mailing Address - Phone:240-481-5704
Mailing Address - Fax:
Practice Address - Street 1:13906 CASTLE BLVD
Practice Address - Street 2:APT 303
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4943
Practice Address - Country:US
Practice Address - Phone:240-481-5704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11932374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide