Basic Information
| Provider Information | |||||||||
| NPI: | 1932163599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOWLING | ||||||||
| FirstName: | JEAN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MEDICAL CENTER DR | ||||||||
| Address2: | P.O. BOX 626 | ||||||||
| City: | BIDDEFORD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040059422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072948405 | ||||||||
| FaxNumber: | 2072829180 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 HEALTHCARE DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | BIDDEFORD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040059449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072824270 | ||||||||
| FaxNumber: | 2072827350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 12/12/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | R019412 | ME | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 363LP0808X | AP081937 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 1932163599 | 01 | ANTHEM | OTHER | 9740400 | 01 | AETNA | OTHER | 1932163599 | 05 | ME | MEDICAID |