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Vigo County

NPI 1053286690ActiveOrganization· Nurse Practitioner, Psych/Mental Health· Terre Haute, IN

Nurse Practitioner, Psych/Mental Health in Terre Haute, Indiana, registered in NPPES in October 2025. The authorized official on file is Mackenzie Goodman, Office Manager.

Overview

NPI1053286690
StatusActive
Entity typeOrganization
NPI issuedOct 6, 2025
Last updated in NPPESOct 6, 2025
Certified by providerOct 6, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Nurse Practitioner, Psych/Mental Health Primary363LP0808X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Nurse Practitioner, Psych/Mental Health providers in Terre Haute

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