MEDICARE: BE WELL HEALTH CLINIC 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
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1962128843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE WELL HEALTH CLINIC LLC

Provider Business Mailing Address
First Line	:	530 BIRCHAM WAY
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-6608
Country	:	US
Telephone Number	:	470-316-6207
Fax Number	:	470-412-6886

Provider Business Practice Location Address
First Line	:	4343 SHALLOWFORD RD STE 720
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-5082
Country	:	US
Telephone Number	:	470-316-6207
Fax Number	:	470-412-6886

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	DIMPLE KRIPALANI
Credential	:
Telephone Number	:	470-316-6207

Provider Enumeration Date	:	10/13/2022
Last Update Date	:	12/15/2025

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