Provider Demographics
NPI:1700294139
Name:KAJENSKI, CARISSA J (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:J
Last Name:KAJENSKI
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 AMHERST ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-4227
Mailing Address - Country:US
Mailing Address - Phone:857-847-5306
Mailing Address - Fax:
Practice Address - Street 1:402 AMHERST ST STE 202
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-4227
Practice Address - Country:US
Practice Address - Phone:857-847-5306
Practice Address - Fax:857-770-9682
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2022-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH054337-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health