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General NPI Number Information
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NPI Number | 1679495477
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Entity Type | Organization
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Legal Business Name | ROOTED TO BLOOM HEALTH ADVOCACY
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 11045 W ARCH CT
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City | MILWAUKEE
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State | WI
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Zip | 53224-2589
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Country | US
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Telephone | 414-436-3367
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Fax |
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Provider Business Mailing Address
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Address Line | 11045 W ARCH CT
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City | MILWAUKEE
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State | WI
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Zip | 53224-2589
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. DIONNE YOUNG
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Credential | NP
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Telephone | 414-708-2442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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