Provider Demographics
NPI:1306436902
Name:CAIAZZO, ANTHONY (APRN-CNP)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:CAIAZZO
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 ELMWOOD RD
Mailing Address - Street 2:
Mailing Address - City:POWNAL
Mailing Address - State:ME
Mailing Address - Zip Code:04069-6311
Mailing Address - Country:US
Mailing Address - Phone:207-776-3012
Mailing Address - Fax:
Practice Address - Street 1:1 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1768
Practice Address - Country:US
Practice Address - Phone:207-406-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP201336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily