Provider Demographics
NPI:1578674065
Name:CAVEN, SARAH C (ANP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:CAVEN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:C
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7027
Mailing Address - Country:US
Mailing Address - Phone:207-795-7575
Mailing Address - Fax:207-795-7133
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7027
Practice Address - Country:US
Practice Address - Phone:207-795-7575
Practice Address - Fax:207-795-7133
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER050985363LA2200X
MECNP81099363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431920299Medicaid
MEP00252745Medicare PIN
MENP515801Medicare PIN
MENP5158Medicare PIN
ME431920299Medicaid