# ROOTED HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205791761
- **Authorized official:** KISUN PETERS-DIAZ (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (917) 861-2531

## Contact information

- **Practice address:** 7610 MAIN ST, SYKESVILLE, MD 21784-7316
- **Practice address phone:** (443) 784-3116
- **Practice address fax:** (888) 649-3015
- **Mailing address:** 405 N CENTER ST STE 25, WESTMINSTER, MD 21157-5126
- **Mailing address phone:** (917) 861-2531
- **Mailing address fax:** (888) 649-3015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/17/2025
- **Last updated:** 12/17/2025