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General NPI Number Information
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NPI Number | 1386478782
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Entity Type | Organization
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Legal Business Name | ACCESS HEALTHCARE AND WELLNESS LLC
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Dates
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Enumeration Date | 08/28/2024
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 4305 NORTHVIEW DR STE 38
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City | BOWIE
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State | MD
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Zip | 20716-2600
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Country | US
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Telephone | 301-235-9999
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Fax | 301-235-9950
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Provider Business Mailing Address
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Address Line | 12308 EUGENES PROSPECT DR
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City | BOWIE
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State | MD
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Zip | 20720-3372
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Country | US
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Telephone | 240-478-4938
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IJEOMAH AHAGHOTU
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Credential |
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Telephone | 301-235-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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