DEEP ROOTS CHARTER SCHOOL NPI 1245020254

NPI Information

  • NPI: 1245020254
  • Provider Name: DEEP ROOTS CHARTER SCHOOL
  • Classification: Nurse Practitioner - 363LS0200X
  • Specialization: School
  • Entity Type: Organization
  • Address: 900 LINDLEY AVE
    PHILADELPHIA, PA
    ZIP 19141
  • Phone: (267) 324-5707

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NPI Details

DEEP ROOTS CHARTER SCHOOL is a school nurse practitioner in Philadelphia, PA. DEEP ROOTS CHARTER SCHOOL NPI is 1245020254. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

900 LINDLEY AVE
PHILADELPHIA, PA
ZIP 19141-920
Phone: (267) 324-5707

The provider's authorized official is Keanna Austin .
The authorized official title is Dorcm and has the following contact phone number (267) 324-5707.

The enumeration date for this NPI number is 5/12/2025 and was last updated on 5/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LS0200XNurse PractitionerSchoolYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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