# JEANINE ROOT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447674049
- **Gender:** F
- **Credential:** ARNP, CRNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 908192 | MS | — |
| 363L00000X | Nurse Practitioner | AP70067675 | WA | — |
| 363L00000X | Nurse Practitioner | SP013693 | PA | Yes |

## Other

- **Enumeration date:** 02/18/2014
- **Last updated:** 08/18/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 103135518 | — | PA |
| 01 | — | 345771 | MEDICARE PTAN- INDIVIDUAL | PA |