Healthcare Provider Details
I. General information
NPI: 1619862935
Provider Name (Legal Business Name): HARMONY ROOTS WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4562 DENROSE CT STE 4
FORT COLLINS CO
80524-8364
US
IV. Provider business mailing address
702 W DRAKE RD
FORT COLLINS CO
80526-5556
US
V. Phone/Fax
- Phone: 970-691-9905
- Fax:
- Phone: 970-691-9905
- Fax: 800-886-9502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QF0050X |
| Taxonomy | Non-Surgical Family Planning Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TREANNA
IRIS
ANASTASIA
Title or Position: FOUNDER, NURSE PRACTITIONER
Credential: WHNP
Phone: 970-231-2373