National Provider Identifier Database

BEWELLNESS LLC
Family


Contact Information

BEWELLNESS, LLC
1315 OAKRIDGE DR STE 100
FORT COLLINS, CO80525-7338
Phone: 970-829-1129
Fax: 949-655-8678
Website:
Specialty Taxonomy Code
* Family 363LF0000X
Psychiatric/Mental Health 363LP0808X
Women's Health 363LW0102X

* Indicates primary specialty

NPI Profile & details for BEWELLNESS, LLC

NPI Number 1356137905
Legal business name
LBN
BEWELLNESS, LLC
Authorized official JENNIFER KELLER DERAAD - (CEO)
Entity Organization
Organization subpart No
Enumeration date 04/18/2025
Last updated 05/14/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • OH Medicaid: 1063793289

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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