# BEWELL- LIFESTYLE & FUNCTIONAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679252084
- **Authorized official:** COLLEEN MEISER RN, MSN, FNP-C (NURSE PRACTITIONER)
- **Authorized official phone:** (434) 294-2416

## Contact information

- **Practice address:** 337 MAIN ST, SMITHFIELD, VA 23430-1346
- **Practice address phone:** (434) 294-2416
- **Mailing address:** 10438 OAK SPRING RD, CARROLLTON, VA 23314-4130
- **Mailing address phone:** (434) 294-2416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/13/2023
- **Last updated:** 07/13/2023