Provider Demographics
NPI:1578085544
Name:WILMOT, CAROLINE JOY (CNP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:JOY
Last Name:WILMOT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 PORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6741
Mailing Address - Country:US
Mailing Address - Phone:207-502-7386
Mailing Address - Fax:207-502-7661
Practice Address - Street 1:83 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6741
Practice Address - Country:US
Practice Address - Phone:207-502-7386
Practice Address - Fax:207-502-7661
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP171072207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine