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Individual
JEANINE ROOT
Active
Individual
JEANINE ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
908192
MS
363L00000X
Nurse Practitioner
AP70067675
WA
363L00000X
Nurse Practitioner
Primary
SP013693
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103135518
—
PA
01
—
345771
MEDICARE PTAN- INDIVIDUAL
PA
Enumeration date
02/18/2014
Last updated
08/18/2026
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