Provider Demographics
NPI:1144802620
Name:EMPOWERED HEALTH SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:EMPOWERED HEALTH SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLETON-LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN
Authorized Official - Phone:980-288-4783
Mailing Address - Street 1:57 UNION ST.
Mailing Address - Street 2:PMB #1225
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-0053
Mailing Address - Country:US
Mailing Address - Phone:980-288-4783
Mailing Address - Fax:980-495-8874
Practice Address - Street 1:57 UNION ST.
Practice Address - Street 2:PMB #1225
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2802
Practice Address - Country:US
Practice Address - Phone:980-288-4783
Practice Address - Fax:980-495-8874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-24
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care