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General NPI Number Information
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NPI Number | 1750170049
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Entity Type | Organization
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Legal Business Name | WILDFLOWER TELEHEALTH NETWORK INC.
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 1555 W SHORELINE DR STE 100
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City | BOISE
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State | ID
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Zip | 83702-9107
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Country | US
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Telephone | 650-864-4320
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 FILLMORE ST # 380-6499
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City | SAN FRANCISCO
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State | CA
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Zip | 94115-1814
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP GROWTH
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Name | NASH PRINCE
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Credential |
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Telephone | 650-864-4320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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