Provider Demographics
NPI:1720616295
Name:JOURNEY HEALTH & WELLNESS
Entity type:Organization
Organization Name:JOURNEY HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:TUCKER
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:804-416-6673
Mailing Address - Street 1:100 CONCOURSE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5751
Mailing Address - Country:US
Mailing Address - Phone:804-416-6673
Mailing Address - Fax:804-886-9046
Practice Address - Street 1:100 CONCOURSE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5751
Practice Address - Country:US
Practice Address - Phone:804-416-6673
Practice Address - Fax:804-886-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty