Healthcare Provider Details

I. General information

NPI: 1073436887
Provider Name (Legal Business Name): HALI HEALTH AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8607 2ND AVE STE 504A
SILVER SPRING MD
20910-3355
US

IV. Provider business mailing address

8607 2ND AVE STE 504A
SILVER SPRING MD
20910-3355
US

V. Phone/Fax

Practice location:
  • Phone: 443-858-8126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANGELA GIMOSE GIMOSE
Title or Position: OWNER
Credential:
Phone: 443-858-8126