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General NPI Number Information
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NPI Number | 1003020462
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Entity Type | Individual
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Provider Name | LAURA LYNN IACONO RD CDN
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 2004 HAYES ST STE 545
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City | NASHVILLE
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State | TN
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Zip | 37203-2655
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Country | US
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Telephone | 629-401-4494
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Fax |
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Provider Business Mailing Address
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Address Line | 170 E MAIN ST STE D127
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2587
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Country | US
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Telephone | 615-854-3243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 834048
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 001919
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 3950
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 001919
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License Number State | NY
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