Provider Demographics
NPI:1619318359
Name:CASE, CARRIE-ANNE HALE (NP)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE-ANNE
Middle Name:HALE
Last Name:CASE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:ANNE
Other - Last Name:CASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 RESERVOIR DR
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-4901
Mailing Address - Country:US
Mailing Address - Phone:978-248-5135
Mailing Address - Fax:978-248-5130
Practice Address - Street 1:81 RESERVOIR DR
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-4901
Practice Address - Country:US
Practice Address - Phone:978-248-5135
Practice Address - Fax:978-248-5130
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2266604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily