| Be Healthy & Well | |
|
9401 Courthouse Rd Chesterfield VA 23832-6690 | |
| (804) 533-7444 | |
| (804) 451-4586 |
| Full Name | Be Healthy & Well |
|---|---|
| Speciality | Clinic/Center |
| Location | 9401 Courthouse Rd, Chesterfield, Virginia |
| Authorized Official Name and Position | Tyra Tanner (CLINICAL DIRECTOR) |
| Authorized Official Contact | 8046215066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Be Healthy & Well Po Box 2947 Chesterfield VA 23832-9118 Ph: (804) 533-7444 | Be Healthy & Well 9401 Courthouse Rd Chesterfield VA 23832-6690 Ph: (804) 533-7444 |
| NPI Number | 1316417918 |
|---|---|
| Provider Enumeration Date | 11/27/2018 |
| Last Update Date | 02/04/2024 |
| Medicare PECOS PAC ID | 5496093635 |
|---|---|
| Medicare Enrollment ID | O20190213000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316417918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
| Provider Name | Tyra Lawanda Tanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326340928 PECOS PAC ID: 0749438927 Enrollment ID: I20180919001560 |
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