IMPACTHEALTH LLC NPI 1104264001

NPI Information

NPI: 1104264001
Provider Name: IMPACTHEALTH, LLC

Other Name: YVETTE JOHNSON

Classification: Registered Nurse - 163WC1500X
Entity Type: Organization

Specialization: Community Health

Address:
3219 N 51ST BLVD
MILWAUKEE, WI
ZIP 53216
Phone: (414) 771-0543
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IMPACTHEALTH, LLC is a community health registered nurse in Milwaukee, WI. IMPACTHEALTH, LLC NPI is 1104264001. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Yvette Johnson.

The provider's business location address is:

3219 N 51ST BLVD
MILWAUKEE, WI
ZIP 53216-235
Phone: (414) 771-0543
Fax: (262) 649-4375

The provider's authorized official is Yvette Johnson .
The authorized official title is President and has the following contact phone number (414) 771-0543.

The enumeration date for this NPI number is 6/13/2013 and was last updated on 1/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WC1500X	Registered Nurse	Community Health	10158-30	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1073805255	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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