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General NPI Number Information
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NPI Number | 1275415424
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Entity Type | Individual
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Provider Name | CARLEY ANN FENNING AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 111 FRANKLIN HEALTH COMMONS
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City | FARMINGTON
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State | ME
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Zip | 04938
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Country | US
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Telephone | 207-778-6031
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Fax |
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Provider Business Mailing Address
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Address Line | 111 FRANKLIN HEALTH COMMONS
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City | FARMINGTON
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State | ME
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Zip | 04938
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Country | US
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Telephone | 207-778-6031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | CNP251489
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | CNP251489
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License Number State | ME
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