Provider Demographics
NPI:1871341552
Name:EMPOWERED WOMEN'S HEALTH & WELLNESS
Entity type:Organization
Organization Name:EMPOWERED WOMEN'S HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/WHNP
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:WHNP
Authorized Official - Phone:443-493-7575
Mailing Address - Street 1:8578 TUCKAHOE RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-1636
Mailing Address - Country:US
Mailing Address - Phone:443-493-7575
Mailing Address - Fax:
Practice Address - Street 1:506 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1380
Practice Address - Country:US
Practice Address - Phone:410-924-0730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty