Provider Demographics
NPI:1902662406
Name:EMPOWERHER WOMEN'S CARE CLINIC
Entity Type:Organization
Organization Name:EMPOWERHER WOMEN'S CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/WOMEN'S HEALTH NURSE PRACT.
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKMON
Authorized Official - Suffix:
Authorized Official - Credentials:WHNP-BC
Authorized Official - Phone:317-932-3426
Mailing Address - Street 1:8038 N 600 W STE 100
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-8605
Mailing Address - Country:US
Mailing Address - Phone:317-932-3426
Mailing Address - Fax:
Practice Address - Street 1:8038 N 600 W STE 100
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-8605
Practice Address - Country:US
Practice Address - Phone:317-932-3426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty