Healthcare Provider Details

I. General information

NPI: 1578489944
Provider Name (Legal Business Name): NEW ROOTS HEALTH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4356 EAST GAIL COURT
GILBERT AZ
85296
US

IV. Provider business mailing address

890 W ELLIOT RD STE 101
GILBERT AZ
85233-5127
US

V. Phone/Fax

Practice location:
  • Phone: 480-330-7412
  • Fax:
Mailing address:
  • Phone: 480-330-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE NDUATI
Title or Position: PROVIDER
Credential: NP
Phone: 480-330-7412