Prairie Roots Wellness, LLC

NPI #1467216275 in Mc Cook, Nebraska

Provider Information

NPI Number: 1467216275
Entity Type: Organization
Organization Name: Prairie Roots Wellness, LLC
Primary Specialty: Physician Assistant
Enumeration Date: Feb 12, 2024
Last Updated: Feb 12, 2024

Practice Location

Address: 801 W C ST
City: Mc Cook
State: Nebraska
ZIP Code: 69001-3591
Phone: (308) 777-2476

Authorized Official

Name: ERICA ELLICOTT, PA-C
Title: PHYSICIAN ASSISTANT
Phone: (308) 883-0658

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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