Healthcare Provider Details

I. General information

NPI: 1023934106
Provider Name (Legal Business Name): FORTITUDE WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13023 THURMOND WAY
CARMEL IN
46074-8424
US

IV. Provider business mailing address

13023 THURMOND WAY
CARMEL IN
46074-8424
US

V. Phone/Fax

Practice location:
  • Phone: 317-332-8896
  • Fax:
Mailing address:
  • Phone: 317-332-8896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: CHRISTA HERRING
Title or Position: NP
Credential:
Phone: 317-332-8896