# BEEWELL CLINIC INC

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

## Provider details

- **NPI number:** 1881413896
- **Authorized official:** NICKLAUS RENDLER (CREDENTIALING AND BUSINESS MANAGER)
- **Authorized official phone:** (719) 251-5132

## Contact information

- **Practice address:** 401 MICHIGAN ST, PUEBLO, CO 81004-2138
- **Practice address phone:** (719) 251-5132
- **Mailing address:** 401 MICHIGAN ST, PUEBLO, CO 81004-2138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2024
- **Last updated:** 10/25/2024