MEDICARE: NU PATHWAY HEALTHCARE AND WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	314000000X	Skilled Nursing Facility
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326753286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NU PATHWAY HEALTHCARE AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	14300 GALLANT FOX LN STE 202
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20715-4033
Country	:	US
Telephone Number	:	301-321-7741
Fax Number	:	301-291-7071

Provider Business Practice Location Address
First Line	:	2015 E WEST HWY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-2602
Country	:	US
Telephone Number	:	301-321-7741
Fax Number	:	301-291-7071

Authorized Official
Title or Position	:	OWNER
Name	:	OWEN GARDNER
Credential	:
Telephone Number	:	301-928-4725

Provider Enumeration Date	:	01/16/2023
Last Update Date	:	07/10/2024

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