Provider Demographics
NPI:1194354365
Name:MEHOUO, JULIENNE II
Entity type:Individual
Prefix:
First Name:JULIENNE
Middle Name:
Last Name:MEHOUO
Suffix:II
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 1:13704 MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1050
Mailing Address - Country:US
Mailing Address - Phone:240-478-0934
Mailing Address - Fax:
Practice Address - Street 1:13704 MILLS AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1050
Practice Address - Country:US
Practice Address - Phone:240-478-0934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA15223374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide