Provider Demographics
NPI:1053320804
Name:CAINES, KAREN ELIZABETH (PHD, CPNP)
Entity Type:Individual
Prefix:PROF
First Name:KAREN
Middle Name:ELIZABETH
Last Name:CAINES
Suffix:
Gender:F
Credentials:PHD, CPNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:96 FALMOUTH ST
Mailing Address - Street 2:P. O. BOX 9300
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04104-9300
Mailing Address - Country:US
Mailing Address - Phone:207-780-4138
Mailing Address - Fax:207-780-4997
Practice Address - Street 1:96 FALMOUTH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04104-9300
Practice Address - Country:US
Practice Address - Phone:207-780-4138
Practice Address - Fax:207-780-4997
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081938363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics