MEDICARE: WELL ROOTED CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1033046578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL ROOTED CARE LLC

Provider Business Mailing Address
First Line	:	6163 GODWIT LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80925-1495
Country	:	US
Telephone Number	:	301-606-7061
Fax Number	:

Provider Business Practice Location Address
First Line	:	6163 GODWIT LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80925-1495
Country	:	US
Telephone Number	:	301-606-7061
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIELLE NICOLE KIRSCHNER
Credential	:	IBCLC
Telephone Number	:	301-606-7061

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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