NPI 1699407502

Wellvana Maryland, LLC

Organisation Preferred Provider Organization Nashville, TN

Practice location

Address: 4840 Centennial Blvd STE 202, Nashville, TN 37209-1792
Phone: (860) 501-7908

Authorised official

Name: Kyle Wailes
Title: Ceo
Phone: (401) 378-7336

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1699407502
Entity type: Organization
NPI issued: 29 Jun 2022
Record last updated: 29 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.