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NPI Code Detail

MEDICARE: ACCESS HEALTHCARE AND WELLNESS LLC

MEDICARE: ACCESS HEALTHCARE AND WELLNESS LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner
2363LF0000XFamily Nurse Practitioner
3363LA2200XAdult Health Nurse Practitioner
4261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1386478782
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACCESS HEALTHCARE AND WELLNESS LLC
Provider Business Mailing Address
First Line : 4305 NORTHVIEW DR STE 38
Second Line :
City : BOWIE
State : MD
Zip : 20716-2600
Country : US
Telephone Number : 301-235-9999
Fax Number : 301-235-9950
Provider Business Practice Location Address
First Line : 4305 NORTHVIEW DR STE 38
Second Line :
City : BOWIE
State : MD
Zip : 20716-2600
Country : US
Telephone Number : 301-235-9999
Fax Number : 301-235-9950
Authorized Official
Title or Position : OWNER
Name : IJEOMAH AHAGHOTU
Credential :
Telephone Number : 301-235-9999
Provider Enumeration Date : 08/28/2024
Last Update Date : 12/09/2025

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Directions to “ACCESS HEALTHCARE AND WELLNESS LLC ” Practice Location

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