Healthcare Provider Details

I. General information

NPI: 1144180837
Provider Name (Legal Business Name): HARMONY ROOTS WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
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

Practice location:
  • Phone: 970-691-9905
  • Fax: 800-886-9502
Mailing address:
  • Phone: 970-691-9905
  • Fax: 800-886-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. TREANNA IRIS ANASTASIA
Title or Position: NURSE PRACTITIONER
Credential: WHNP
Phone: 970-231-2373