Provider Demographics
NPI:1750092433
Name:FLOWERS, TALLEY (PMHNP)
Entity type:Individual
Prefix:
First Name:TALLEY
Middle Name:
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 LONGSOUGHT RD
Mailing Address - Street 2:
Mailing Address - City:WILDERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38388-7603
Mailing Address - Country:US
Mailing Address - Phone:731-798-1851
Mailing Address - Fax:
Practice Address - Street 1:1186 HWY 45 BYPASS
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3256
Practice Address - Country:US
Practice Address - Phone:731-215-0502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN171480363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health