MEDICARE: BEEWELL NUTRITION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	133N00000X	Nutritionist
2	374J00000X	Doula
3	133NN1002X	Nutrition Education Nutritionist
4	133V00000X	Registered Dietitian
5	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1437024536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEEWELL NUTRITION, LLC

Provider Business Mailing Address
First Line	:	500 E 4TH ST STE 125
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-4011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E 4TH ST STE 125
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-4011
Country	:	US
Telephone Number	:	443-845-6946
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JEREMY CRABB
Credential	:
Telephone Number	:	443-845-6946

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	05/29/2026

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