Individual
KARISSA A FAHNESTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
46 FAIRVIEW AVE, SUITE 114, SKOWHEGAN, ME 04976-1481
(207) 474-6943
(207) 474-6946
Mailing address
PO BOX 468, SKOWHEGAN, ME 04976-0468
(207) 858-8353
(207) 474-9261
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA281
ME
Other
Enumeration date
01/20/2010
Last updated
09/27/2018
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