=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013830728
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEE WELL MEDICAL CENTER PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/30/2026
-----------------------------------------------------
Last Update Date | 07/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 412 N C ST
-----------------------------------------------------
City | CRIPPLE CREEK
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80813-5052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-625-1311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 36257 QUIETUDE LN
-----------------------------------------------------
City | KIOWA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80117-9038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-625-1311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AMBYR HODKINS
-----------------------------------------------------
Credential | FNP-C
-----------------------------------------------------
Telephone | 720-625-1311
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------