Provider Demographics
NPI:1952138208
Name:EMPOWER HEALTH AND HORMONES
Entity type:Organization
Organization Name:EMPOWER HEALTH AND HORMONES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEIS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNM
Authorized Official - Phone:502-792-9363
Mailing Address - Street 1:3322 STRATFORD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-1011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3322 STRATFORD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-1011
Practice Address - Country:US
Practice Address - Phone:502-792-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty