MEDICARE: EMPOWERMENT HEALTH SOLUTIONS LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1598510083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWERMENT HEALTH SOLUTIONS LLC.

Provider Business Mailing Address
First Line	:	4290 MACSWAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4257
Country	:	US
Telephone Number	:	614-604-9847
Fax Number	:	614-863-9601

Provider Business Practice Location Address
First Line	:	4290 MACSWAY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4257
Country	:	US
Telephone Number	:	614-604-9847
Fax Number	:	614-863-9601

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ANTHONIA NZIKA
Credential	:	PMHNP
Telephone Number	:	614-604-9847

Provider Enumeration Date	:	04/18/2024
Last Update Date	:	04/18/2024

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