Provider Demographics
NPI:1336912559
Name:WILDFLOWER PSYCHIATRY LLC
Entity Type:Organization
Organization Name:WILDFLOWER PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:615-488-5218
Mailing Address - Street 1:541 TAFFY WAY
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2439
Mailing Address - Country:US
Mailing Address - Phone:419-376-3371
Mailing Address - Fax:
Practice Address - Street 1:210 25TH AVE N STE 601
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1631
Practice Address - Country:US
Practice Address - Phone:615-488-5218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty