Healthcare Provider Details

I. General information

NPI: 1245106459
Provider Name (Legal Business Name): WILDFLOWER PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W 14TH ST
CROWLEY LA
70526-2802
US

IV. Provider business mailing address

118 W 14TH ST
CROWLEY LA
70526-2802
US

V. Phone/Fax

Practice location:
  • Phone: 225-892-6178
  • Fax:
Mailing address:
  • Phone: 337-514-2400
  • Fax: 337-514-4718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIANE CHAPMAN
Title or Position: OWNER/ NURSE PRACTITIONER
Credential: CPNP
Phone: 225-892-6178