Provider Demographics
NPI:1447568662
Name:ROOT, KATHLEEN M (RN)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:M
Last Name:ROOT
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:2 MURRAY HILL DR
Mailing Address - Street 2:LIVINGSTON COUNTY DEPARTMENT OF HEALTH
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1122
Mailing Address - Country:US
Mailing Address - Phone:585-243-7299
Mailing Address - Fax:
Practice Address - Street 1:2 MURRAY HILL DR
Practice Address - Street 2:LIVINGSTON COUNTY DEPARTMENT OF HEALTH
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1122
Practice Address - Country:US
Practice Address - Phone:585-243-7299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY22354578163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse