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General NPI Number Information
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NPI Number | 1497015200
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Entity Type | Individual
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Provider Name | KATHRYN MARY JOLIN PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 69 HIGH ST
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City | DOVER FOXCROFT
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State | ME
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Zip | 04426-1270
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Country | US
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Telephone | 207-564-4110
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Fax | 207-564-4478
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Provider Business Mailing Address
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Address Line | 69 HIGH ST
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City | DOVER FOXCROFT
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State | ME
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Zip | 04426-1270
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Country | US
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Telephone | 207-564-4110
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Fax | 207-564-4478
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60525906
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP111094
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License Number State | ME
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