Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | R040480 | ME |
NPI | 1033105135 |
---|---|
Provider Name | Ms. Carrie Elizabeth Levine |
First Address | Newcastle, ME 04553 |
Second Address | Newcastle, ME 04553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 17/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061053 | ANTHEM (01) | ME |
P34763 | (02) | |
P34763 | (02) | ME |