Provider Demographics
NPI:1487086658
Name:GAULIN, JENNIFER (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GAULIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:KESARIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:71 HALIFAX ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6930
Mailing Address - Country:US
Mailing Address - Phone:207-249-6610
Mailing Address - Fax:207-249-6618
Practice Address - Street 1:71 HALIFAX ST
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901-6930
Practice Address - Country:US
Practice Address - Phone:207-249-6610
Practice Address - Fax:207-249-6618
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN55097163W00000X
MECNP131067363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse