Provider Demographics
NPI:1386531259
Name:ROOTED WELLNESS OF COSHOCTON LLC
Entity type:Organization
Organization Name:ROOTED WELLNESS OF COSHOCTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNP
Authorized Official - Phone:740-294-9223
Mailing Address - Street 1:29340 TOWNSHIP ROAD 338
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:OH
Mailing Address - Zip Code:43844-9622
Mailing Address - Country:US
Mailing Address - Phone:740-294-9223
Mailing Address - Fax:740-294-9223
Practice Address - Street 1:1101 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1323
Practice Address - Country:US
Practice Address - Phone:740-294-9223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care