=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689648487
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELLE HOPKINS CARNES ANP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2006
-----------------------------------------------------
Last Update Date | 09/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 887 CONGRESS ST STE 400
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04102-3163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-774-6368
-----------------------------------------------------
Fax | 207-774-9388
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 887 CONGRESS ST STE 400
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04102-3163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-774-6368
-----------------------------------------------------
Fax | 207-774-9388
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | AP1929
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WR0006X
-----------------------------------------------------
Taxonomy Name | Registered Nurse First Assistant
-----------------------------------------------------
License Number | RN098519
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | CNP251471
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | CNP251471
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------