Provider Demographics
NPI:1366325367
Name:WESTERCAMP WELLNESS LLC
Entity type:Organization
Organization Name:WESTERCAMP WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTERCAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-265-3401
Mailing Address - Street 1:848 BAYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-3000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:848 BAYSIDE DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3000
Practice Address - Country:US
Practice Address - Phone:765-265-3401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty