WABASH VALLEY DERMATOLOGY AND MED SPA INC
NPI 1619561479
Nurse Practitioner - Family in Terre Haute, IN

Q: What is Wabash Valley Dermatology And Med Spa Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since February 23, 2021

4949 E POPLAR DR, TERRE HAUTE, IN 47803(217) 712-9512 Get Directions Write a Review

NPPES record last updated: February 23, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Wabash Valley Dermatology And Med Spa Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WABASH VALLEY DERMATOLOGY AND MED SPA INC (NPI 1619561479) is a healthcare organization registered as a family in Terre Haute, Indiana and active in the NPI registry since February 2021. The organization lists Lindsay Susan Wilson, President, as its authorized official.

NPPES Registry Identity

NPI1619561479

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameWABASH VALLEY DERMATOLOGY AND MED SPA INC

Location Address4949 E POPLAR DRTerre Haute, IN 47803-2434

Mailing Address18017 N Weaver RdMarshall, IL 62441-4071 · (217) 712-9512

Phone(217) 712-9512

Organization SubpartNo

Authorized OfficialLindsay Susan WilsonPresident · (217) 712-9512

Enumeration DateFebruary 23, 2021

NPPES CertifiedFebruary 23, 2021

✔ NPI 1619561479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

4949 E POPLAR DR, Terre Haute, IN 47803

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DARLA HECK SACOPULOS PC

Optometrist

4949 E POPLAR DR
TERRE HAUTE, IN 47803

Vigo County (812) 872-2020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wabash Valley Dermatology And Med Spa Inc's NPI number?

The NPI number for Wabash Valley Dermatology And Med Spa Inc is 1619561479. It was assigned to this organization in the NPPES registry on February 23, 2021.

Where is Wabash Valley Dermatology And Med Spa Inc located?

Wabash Valley Dermatology And Med Spa Inc is located at 4949 E Poplar Dr, Terre Haute, IN 47803. The listed phone number is (217) 712-9512.

What is Wabash Valley Dermatology And Med Spa Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Wabash Valley Dermatology And Med Spa Inc was last updated on February 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.