Individual
WENDY ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2 ESSEX CENTER DR, PEABODY, MA 01960-2902
(978) 977-4000
Mailing address
147 MILK ST, BOSTON, MA 02109-4806
(617) 421-2508
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
102300
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0356590
—
MA
01
—
N284
HPHC
MA
01
—
NP1352
BCBS
MA
Enumeration date
01/19/2007
Last updated
07/08/2007
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