MEDICARE: ARISE WELLNESS CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1548125164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARISE WELLNESS CLINIC

Provider Business Mailing Address
First Line	:	6707 PANTHER WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-9471
Country	:	US
Telephone Number	:	317-851-0966
Fax Number	:	317-934-1694

Provider Business Practice Location Address
First Line	:	6707 PANTHER WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-9471
Country	:	US
Telephone Number	:	317-851-0966
Fax Number	:	317-934-1694

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	JESSI WILD
Credential	:	LMHC
Telephone Number	:	317-279-5583

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	01/21/2026

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Directions to “ARISE WELLNESS CLINIC ” Practice Location

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