Healthcare Provider Details

I. General information

NPI: 1568266450
Provider Name (Legal Business Name): WELL RESTED SLEEP SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8066 WALNUT RUN RD STE 100
CORDOVA TN
38018-8842
US

IV. Provider business mailing address

8066 WALNUT RUN RD STE 100
CORDOVA TN
38018-8842
US

V. Phone/Fax

Practice location:
  • Phone: 901-881-2260
  • Fax: 901-881-0680
Mailing address:
  • Phone: 901-219-6515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALICIA WONG
Title or Position: OWNER
Credential:
Phone: 901-219-6515