Healthcare Provider Details

I. General information

NPI: 1063385227
Provider Name (Legal Business Name): ADOBE ROOTS HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 APACHE RIDGE RD
SANTA FE NM
87505-8906
US

IV. Provider business mailing address

51 APACHE RIDGE RD
SANTA FE NM
87505-8906
US

V. Phone/Fax

Practice location:
  • Phone: 505-470-1094
  • Fax:
Mailing address:
  • Phone: 505-470-1094
  • Fax: 949-682-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MIRANDA NYRIE OAKELEY
Title or Position: OWNER
Credential: CNP
Phone: 505-470-1094