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General NPI Number Information
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NPI Number | 1588323059
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Entity Type | Organization
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Legal Business Name | NU PATHWAY HEALTHCARE AND WELLNESS LLC
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 4500 FORBES BLVD
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City | LANHAM
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State | MD
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Zip | 20706-6312
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Country | US
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Telephone | 202-321-7741
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Fax | 202-291-7071
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Provider Business Mailing Address
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Address Line | 4500 FORBES BLVD
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City | LANHAM
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State | MD
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Zip | 20706-6312
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Country | US
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Telephone | 202-321-7741
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Fax | 202-291-7071
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Authorized Official
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Title or Position | OWNER
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Name | OWEN GARDNER
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Credential |
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Telephone | 301-928-4725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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