Provider Demographics
NPI:1497015200
Name:JOLIN, KATHRYN MARY (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARY
Last Name:JOLIN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426-1270
Mailing Address - Country:US
Mailing Address - Phone:207-564-4110
Mailing Address - Fax:207-564-4478
Practice Address - Street 1:69 HIGH ST
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1270
Practice Address - Country:US
Practice Address - Phone:207-564-4110
Practice Address - Fax:207-564-4478
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60525906363LP0808X
MECNP111094363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health