MEDICARE: BETTER HEALTH & WELNESS 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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1407610702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETTER HEALTH & WELNESS CLINIC LLC

Provider Business Mailing Address
First Line	:	15504 CRYSTAL VALLEY WAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-6904
Country	:	US
Telephone Number	:	502-855-0193
Fax Number	:

Provider Business Practice Location Address
First Line	:	9131 FERN CREEK RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-2711
Country	:	US
Telephone Number	:	502-855-0193
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DEV SUBEDI
Credential	:
Telephone Number	:	502-855-0193

Provider Enumeration Date	:	02/08/2024
Last Update Date	:	02/08/2024

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