Organization
ROOTED HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KISUN PETERS-DIAZ (EXECUTIVE DIRECTOR)
(917) 861-2531
Entity
Organization
Contact information
Practice address
7610 MAIN ST, SYKESVILLE, MD 21784-7316
(443) 784-3116
(888) 649-3015
Mailing address
405 N CENTER ST STE 25, WESTMINSTER, MD 21157-5126
(917) 861-2531
(888) 649-3015
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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