Provider Demographics
NPI:1114382249
Name:CARNES, MARIE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:CARNES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:CARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1978
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1978
Mailing Address - Country:US
Mailing Address - Phone:410-749-1015
Mailing Address - Fax:410-749-0654
Practice Address - Street 1:1817 OLD VIRGINIA RD
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-3049
Practice Address - Country:US
Practice Address - Phone:410-651-4040
Practice Address - Fax:888-843-8455
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC006196363LP0200X
VA0024178705363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid