Provider Demographics
NPI:1417793977
Name:EMPOWERWELLNESS, LLC
Entity type:Organization
Organization Name:EMPOWERWELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:MCWHIRTER
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:603-793-6453
Mailing Address - Street 1:775 RED BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-3227
Mailing Address - Country:US
Mailing Address - Phone:603-793-6453
Mailing Address - Fax:888-226-6531
Practice Address - Street 1:775 RED BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-3227
Practice Address - Country:US
Practice Address - Phone:603-793-6453
Practice Address - Fax:888-226-6531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service