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Organization
DIGITAL HEALTH INNOVATION LEARNING LAB
Active
Organization
DIGITAL HEALTH INNOVATION LEARNING LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE ALLEN MBA (GENERAL MANAGER)
(989) 708-0349
Entity
Organization
Contact information
Practice address
1519 MECKLENBURG HWY UNIT 362, MOORESVILLE, NC 28123-2016
(989) 708-0349
Mailing address
1519 MECKLENBURG HWY UNIT 362, MOORESVILLE, NC 28123-2016
(989) 708-0349
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YS0200X
School Counselor
—
NULL
101YS0200X
School Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
NULL
1041S0200X
School Social Worker
—
—
1223D0001X
Public Health Dentistry
—
NULL
1223D0001X
Public Health Dentistry
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
163WC1500X
Community Health Registered Nurse
—
NULL
163WC1500X
Community Health Registered Nurse
—
—
163WG0000X
General Practice Registered Nurse
—
NULL
163WG0000X
General Practice Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
NULL
164W00000X
Licensed Practical Nurse
—
—
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
NULL
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
NULL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
363LC1500X
Community Health Nurse Practitioner
—
NULL
363LC1500X
Community Health Nurse Practitioner
—
—
364SC1501X
Community Health/Public Health Clinical Nurse Specialist
—
NULL
364SC1501X
Community Health/Public Health Clinical Nurse Specialist
—
—
Other
Enumeration date
04/03/2025
Last updated
04/04/2025
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