Provider Demographics
NPI:1235969361
Name:WILDFLOWER INTEGRATIVE HEALTH PLLC
Entity type:Organization
Organization Name:WILDFLOWER INTEGRATIVE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN
Authorized Official - Phone:615-893-0316
Mailing Address - Street 1:107 BUTTE CT
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:TN
Mailing Address - Zip Code:37037-6158
Mailing Address - Country:US
Mailing Address - Phone:615-796-1335
Mailing Address - Fax:
Practice Address - Street 1:621 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4923
Practice Address - Country:US
Practice Address - Phone:615-893-0316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty