Provider Demographics
NPI:1518185917
Name:MILLHOUSE, CAROLYN SUE (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:SUE
Last Name:MILLHOUSE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6729
Mailing Address - Country:US
Mailing Address - Phone:207-535-1200
Mailing Address - Fax:207-535-1249
Practice Address - Street 1:385 ROUTE 1
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6729
Practice Address - Country:US
Practice Address - Phone:207-535-1200
Practice Address - Fax:207-535-1249
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily