Healthcare Provider Details

I. General information

NPI: 1033046578
Provider Name (Legal Business Name): WELL ROOTED CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6163 GODWIT LN
COLORADO SPRINGS CO
80925-1495
US

IV. Provider business mailing address

6163 GODWIT LN
COLORADO SPRINGS CO
80925-1495
US

V. Phone/Fax

Practice location:
  • Phone: 301-606-7061
  • Fax:
Mailing address:
  • Phone: 301-606-7061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE NICOLE KIRSCHNER
Title or Position: OWNER
Credential: IBCLC
Phone: 301-606-7061