Individual
HALEY ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(267) 426-4480
Mailing address
1512 SOUTH ST # 3F, PHILADELPHIA, PA 19146-1636
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP035522
PA
Other
Enumeration date
03/19/2026
Last updated
03/19/2026
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