Healthcare Provider Details

I. General information

NPI: 1962128843
Provider Name (Legal Business Name): BE WELL HEALTH CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 SHALLOWFORD RD STE 720
MARIETTA GA
30062-5082
US

IV. Provider business mailing address

530 BIRCHAM WAY
ROSWELL GA
30075-6608
US

V. Phone/Fax

Practice location:
  • Phone: 470-316-6207
  • Fax: 470-412-6886
Mailing address:
  • Phone: 470-316-6207
  • Fax: 470-412-6886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DIMPLE KRIPALANI
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 470-316-6207