Provider Demographics
NPI:1396476321
Name:PURPLE FLOWER COMMUNITY HEALTH AND WELLNESS FOUNDATION
Entity type:Organization
Organization Name:PURPLE FLOWER COMMUNITY HEALTH AND WELLNESS FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FNP/FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:901-387-6858
Mailing Address - Street 1:6220 GREENLEE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8447
Mailing Address - Country:US
Mailing Address - Phone:901-387-6858
Mailing Address - Fax:833-949-3967
Practice Address - Street 1:6220 GREENLEE ST STE 6
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-8447
Practice Address - Country:US
Practice Address - Phone:901-387-6858
Practice Address - Fax:901-317-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care