Individual
JEANINE ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, CRNP
Contact information
Practice address
621 S MAIN ST, DU BOIS, PA 15801-1413
(814) 371-0600
(814) 372-4764
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-0600
(814) 372-4764
Taxonomy
Speciality
Code
Description
License number
State
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
03/18/2026
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