Provider Demographics
NPI:1952985798
Name:NWI HEALTH & WELLNESS
Entity Type:Organization
Organization Name:NWI HEALTH & WELLNESS
Other - Org Name:NWI HEALTH & WELLNESS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-769-1670
Mailing Address - Street 1:1051 SOUTHPOINT CIR STE F
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-6256
Mailing Address - Country:US
Mailing Address - Phone:219-252-4892
Mailing Address - Fax:
Practice Address - Street 1:1051 SOUTHPOINT CIR STE F
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-6256
Practice Address - Country:US
Practice Address - Phone:219-252-4892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty