Iconic Nurse Network Outreach, INC
Community Health Worker in Rockford, IL. Organization (NPI-2).
NPI number1669215141
StatusActive
Last updated in NPPESJun 13, 2024
Details
- NPI
- 1669215141
- Entity type
- Organization (NPI-2)
- Legal business name
- Iconic Nurse Network Outreach, INC
- Organization subpart
- No
- Enumeration date
- Jun 13, 2024
- Certification date
- Jun 13, 2024
- Last updated
- Jun 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
| 163W00000X | Registered Nurse | – | – | |
| 163WW0000X | Registered Nurse, Wound Care | – | – | |
| 251B00000X | Case Management | – | – | |
| 364SC1501X | Clinical Nurse Specialist, Community Health/Public Health | – | – |
Other names
- Iconic Health Academy (Doing Business As)
Practice location
730 N Church St # Ll-3Rockford, IL 61103-6917
Phone 312-931-7376
Mailing address
730 N Church St # Ll-3Rockford, IL 61103-6917
Phone 312-931-7376
Authorized official
Lakhila Tellis
Founder/President
3124688604
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