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General NPI Number Information
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NPI Number | 1487514006
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Entity Type | Organization
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Legal Business Name | HER VITAL WELLNESS, LLC
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Dates
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Enumeration Date | 11/15/2025
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 7262 FISHERS CROSSING DR
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City | FISHERS
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State | IN
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Zip | 46038-2793
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Country | US
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Telephone | 317-434-4341
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Fax |
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Provider Business Mailing Address
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Address Line | 5625 N GERMAN CHURCH RD UNIT 2274
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-8513
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEAH WONG
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Credential | MSN, APRN, FNP-C
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Telephone | 317-434-4341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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