Healthcare Provider Details

I. General information

NPI: 1316775091
Provider Name (Legal Business Name): JOURNEY2WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E GOLD COAST RD STE 340
PAPILLION NE
68046-4131
US

IV. Provider business mailing address

909 N ADAMS ST UNIT 460700
PAPILLION NE
68046-3078
US

V. Phone/Fax

Practice location:
  • Phone: 402-884-9059
  • Fax: 833-875-0053
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LATRICE MARTIN
Title or Position: OWNER
Credential: DNP
Phone: 402-884-9059