Healthcare Provider Details

I. General information

NPI: 1215890173
Provider Name (Legal Business Name): KALOS WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 GLENALLAN AVE
SILVER SPRING MD
20906-3541
US

IV. Provider business mailing address

2431 GLENALLAN AVE
SILVER SPRING MD
20906-3541
US

V. Phone/Fax

Practice location:
  • Phone: 301-679-3095
  • Fax: 301-597-7356
Mailing address:
  • Phone: 301-679-3095
  • Fax: 301-597-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRISTA ONEIL
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 301-679-3095