Healthcare Provider Details

I. General information

NPI: 1053320804
Provider Name (Legal Business Name): KAREN ELIZABETH CAINES PHD, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 FALMOUTH ST
PORTLAND ME
04104-9300
US

IV. Provider business mailing address

96 FALMOUTH ST P. O. BOX 9300
PORTLAND ME
04104-9300
US

V. Phone/Fax

Practice location:
  • Phone: 207-780-4138
  • Fax: 207-780-4997
Mailing address:
  • Phone: 207-780-4138
  • Fax: 207-780-4997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP081938
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: