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NPI Code Detail

MEDICARE: ROOTED WELLNESS OF COSHOCTON LLC

MEDICARE: ROOTED WELLNESS OF COSHOCTON 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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1386531259
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROOTED WELLNESS OF COSHOCTON LLC
Provider Business Mailing Address
First Line : 29340 TR 338
Second Line :
City : WARSAW
State : OH
Zip : 43844-9622
Country : US
Telephone Number : 740-294-9223
Fax Number : 740-294-9223
Provider Business Practice Location Address
First Line : 1101 CHESTNUT ST
Second Line :
City : COSHOCTON
State : OH
Zip : 43812-1323
Country : US
Telephone Number : 740-294-9223
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER
Name : DAWN ELLEN WHITE
Credential : APRN, CNP
Telephone Number : 740-294-9223
Provider Enumeration Date : 06/23/2025
Last Update Date : 10/01/2025

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Directions to “ROOTED WELLNESS OF COSHOCTON LLC ” Practice Location

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