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General NPI Number Information
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NPI Number | 1437002078
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Entity Type | Organization
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Legal Business Name | WEIGHTWISE VIRTUAL CLINIC, LLC
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 3550 WOODGATE CT
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City | WHEATFIELD
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State | IN
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Zip | 46392
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Country | US
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Telephone | 317-979-0733
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Fax | 814-292-9196
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Provider Business Mailing Address
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Address Line | 2106 MORTHLAND DR
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City | VALPARAISO
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State | IN
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Zip | 46383-5914
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Country | US
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Telephone |
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Fax | 814-292-9196
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Authorized Official
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Title or Position | DOCTOR OF NURSING PRACTICE
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Name | DR. DESIREE ELIZABETH SAMPLES
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Credential | DNP, RN, FNP-BC
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Telephone | 317-979-0733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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