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General NPI Number Information
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NPI Number | 1386531259
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Entity Type | Organization
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Legal Business Name | ROOTED WELLNESS OF COSHOCTON LLC
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 1101 CHESTNUT ST
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City | COSHOCTON
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State | OH
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Zip | 43812-1323
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Country | US
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Telephone | 740-294-9223
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Fax |
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Provider Business Mailing Address
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Address Line | 29340 TR 338
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City | WARSAW
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State | OH
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Zip | 43844-9622
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Country | US
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Telephone | 740-294-9223
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Fax | 740-294-9223
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DAWN ELLEN WHITE
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Credential | APRN, CNP
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Telephone | 740-294-9223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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