Provider Demographics
NPI:1063385227
Name:ADOBE ROOTS HEALTH & WELLNESS
Entity type:Organization
Organization Name:ADOBE ROOTS HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:NYRIE
Authorized Official - Last Name:OAKELEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:505-470-1094
Mailing Address - Street 1:51 APACHE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-8906
Mailing Address - Country:US
Mailing Address - Phone:505-470-1094
Mailing Address - Fax:
Practice Address - Street 1:51 APACHE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-8906
Practice Address - Country:US
Practice Address - Phone:505-470-1094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty