Provider Demographics
NPI:1699751016
Name:CLINE, ERIK CARAWAN (CRNA)
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:CARAWAN
Last Name:CLINE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-0404
Mailing Address - Country:US
Mailing Address - Phone:207-973-4519
Mailing Address - Fax:
Practice Address - Street 1:489 STATE ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6616
Practice Address - Country:US
Practice Address - Phone:207-973-4519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-17
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERNA83401367500000X
MERN R053637367500000X
FLRN 2860722367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000098605OtherMEDICARE P-TAN FOR BHMH
ME200051OtherMED B - BHMH
ME00098601OtherFOR EMMC