MEDICARE: INFINITE JOURNEY NP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1740122910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITE JOURNEY NP LLC

Provider Business Mailing Address
First Line	:	2264 DAWN LN
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-4213
Country	:	US
Telephone Number	:	443-579-5590
Fax Number	:

Provider Business Practice Location Address
First Line	:	9652 MARLBORO PIKE STE 6
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3767
Country	:	US
Telephone Number	:	443-579-5590
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAQUIDA JOHNSON
Credential	:	MSN, PMHNP-BC
Telephone Number	:	301-537-3606

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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