Provider Demographics
NPI:1386069656
Name:BE WELL HEALTHCARE INC
Entity type:Organization
Organization Name:BE WELL HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTICTIONER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:405-623-6269
Mailing Address - Street 1:20677 DEER HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-9078
Mailing Address - Country:US
Mailing Address - Phone:405-570-9533
Mailing Address - Fax:
Practice Address - Street 1:20677 DEER HOLLOW DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-9078
Practice Address - Country:US
Practice Address - Phone:405-570-9533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR78861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200294910AMedicaid
OK78861OtherSTATE NURSING LISCENSE
OK78861OtherSTATE NURSING LISCENSE
OK78861OtherSTATE NURSING LISCENSE