Healthcare Provider Details

I. General information

NPI: 1801641477
Provider Name (Legal Business Name): NU PATHWAY HEALTHCARE AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 NEWTON ST NW
WASHINGTON DC
20010-1017
US

IV. Provider business mailing address

14300 GALLANT FOX LN STE 202
BOWIE MD
20715-4033
US

V. Phone/Fax

Practice location:
  • Phone: 202-932-8149
  • Fax: 301-291-7071
Mailing address:
  • Phone: 202-932-8149
  • Fax: 301-291-7071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OWEN GARDNER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 301-928-4725