Provider Demographics
NPI:1932163599
Name:DOWLING, JEAN M (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:M
Last Name:DOWLING
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:P.O. BOX 626
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-294-8405
Mailing Address - Fax:207-282-9180
Practice Address - Street 1:9 HEALTHCARE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9449
Practice Address - Country:US
Practice Address - Phone:207-282-4270
Practice Address - Fax:207-282-7350
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER019412367A00000X
MEAP081937363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932163599OtherANTHEM
9740400OtherAETNA
ME1932163599Medicaid
ME1932163599Medicaid