Provider Demographics
NPI:1750170049
Name:WILDFLOWER TELEHEALTH NETWORK INC.
Entity type:Organization
Organization Name:WILDFLOWER TELEHEALTH NETWORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP GROWTH
Authorized Official - Prefix:
Authorized Official - First Name:NASH
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-864-4320
Mailing Address - Street 1:2443 FILLMORE ST # 380-6499
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1555 W SHORELINE DR STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-9107
Practice Address - Country:US
Practice Address - Phone:650-864-4320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILDFLOWER TELEHEALTH NETWORK INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty