Root, Jeanine

Root, Jeanine is an individual health care provider with primary practice located at 621 S Main St , Du Bois PA 15801-1413. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Root, Jeanine can be contacted via phone (814) 371-0600.

Contact Information

Primary practice address
621 S Main St Du Bois PA 15801-1413
Phone: (814) 371-0600
Fax: (814) 372-4764
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X SP013693 Pennsylvania

Profile Details

NPI number 1447674049
LBN Legal business name Root, Jeanine
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2014
Last updated Apr 26th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447674049 NPPES
Pennsylvania Other 345771 MEDICARE PTAN- INDIVIDUAL
Pennsylvania MEDICAID 103135518 MEDICARE PTAN- INDIVIDUAL

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