Provider Demographics
NPI:1093404329
Name:BEWELL PRIMARY CARE PLLC
Entity type:Organization
Organization Name:BEWELL PRIMARY CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEINHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC
Authorized Official - Phone:802-753-7785
Mailing Address - Street 1:210 SOUTH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-2894
Mailing Address - Country:US
Mailing Address - Phone:802-753-7785
Mailing Address - Fax:802-753-7082
Practice Address - Street 1:210 SOUTH ST STE 4
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2894
Practice Address - Country:US
Practice Address - Phone:802-753-7785
Practice Address - Fax:802-753-7082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty