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General NPI Number Information
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NPI Number | 1801717079
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Entity Type | Organization
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Legal Business Name | ROOTED LIFE HEALTH LLC
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 551 CAMDEN PARK DR
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City | COVINGTON
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State | LA
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Zip | 70435-0256
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Country | US
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Telephone | 720-774-0729
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Fax | 983-203-9632
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Provider Business Mailing Address
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Address Line | 551 CAMDEN PARK DR
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City | COVINGTON
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State | LA
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Zip | 70435-0256
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Country | US
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Telephone | 720-774-0729
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Fax | 983-203-9632
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | JESSICA GARAUDY
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Credential | RDN
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Telephone | 720-774-0729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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