Organization
ROOTED HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA M GROSS NP (NURSE PRACTITIONER)
(320) 249-6541
Entity
Organization
Contact information
Practice address
3620 BEMIDJI AVE N, BEMIDJI, MN 56601-4333
(320) 249-6541
Mailing address
3620 BEMIDJI AVE N, BEMIDJI, MN 56601-4333
(320) 249-6541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629451869
—
MN
Enumeration date
01/16/2024
Last updated
01/16/2024
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