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General NPI Number Information
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NPI Number | 1114672599
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Entity Type | Organization
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Legal Business Name | EMPOWERME NP, LLC
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 1520 E BATES
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City | SPRINGFIELD
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State | MO
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Zip | 65804-8425
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Country | US
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Telephone | 844-502-7996
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 736522
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City | DALLAS
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State | TX
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Zip | 75373-6522
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Country | US
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Telephone | 844-502-7996
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | JOHN DAVID CHURCH
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Credential |
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Telephone | 618-972-5228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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