Healthcare Provider Details

I. General information

NPI: 1396476321
Provider Name (Legal Business Name): PURPLE FLOWER COMMUNITY HEALTH AND WELLNESS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 GREENLEE ST STE 6
ARLINGTON TN
38002-8447
US

IV. Provider business mailing address

6220 GREENLEE ST STE 6
ARLINGTON TN
38002-8447
US

V. Phone/Fax

Practice location:
  • Phone: 901-387-6858
  • Fax: 901-317-6432
Mailing address:
  • Phone: 901-387-6858
  • Fax: 833-949-3967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA CAMPBELL
Title or Position: FNP/FOUNDER
Credential: FNP
Phone: 901-387-6858