Provider Demographics
NPI:1033105135
Name:LEVINE, CARRIE ELIZABETH (CNM)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:LEVINE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 RIVER ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553
Mailing Address - Country:US
Mailing Address - Phone:207-563-4000
Mailing Address - Fax:207-563-7003
Practice Address - Street 1:608 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:ME
Practice Address - Zip Code:04553
Practice Address - Country:US
Practice Address - Phone:207-846-6163
Practice Address - Fax:207-846-6167
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER040480176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME061053OtherANTHEM
ME061053OtherANTHEM
P34763Medicare UPIN
MEP34763Medicare UPIN