MEDICARE: EMPOWER WELLNESS 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	251S00000X	Community/Behavioral Health Agency
2	374J00000X	Doula

General Provider Information

NPI Number	:	1649141987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER WELLNESS LLC

Provider Business Mailing Address
First Line	:	1665 HARTFORD AVE UNIT BOX 4
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-3200
Country	:	US
Telephone Number	:	401-237-0131
Fax Number	:

Provider Business Practice Location Address
First Line	:	1665 HARTFORD AVE STE 4
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-3268
Country	:	US
Telephone Number	:	401-237-0131
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NICOLE JILL WHALEN
Credential	:
Telephone Number	:	401-300-7542

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	01/26/2026

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Directions to “EMPOWER WELLNESS LLC ” Practice Location

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