Provider Demographics
NPI:1619203270
Name:HANKINS, CARRISSA BETH (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CARRISSA
Middle Name:BETH
Last Name:HANKINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:CARRISSA
Other - Middle Name:BETH
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:76 HIGH ST.
Mailing Address - Street 2:STE. 300
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240
Mailing Address - Country:US
Mailing Address - Phone:207-795-5978
Mailing Address - Fax:207-795-5645
Practice Address - Street 1:76 HIGH ST.
Practice Address - Street 2:STE. 300
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-795-5978
Practice Address - Fax:207-795-5645
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP91062363LF0000X
MEAP091062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily