Individual
JANE GALLAUDET WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
114 BATH RD, BRUNSWICK, ME 04011-2606
(207) 798-4400
(207) 798-4452
Mailing address
PO BOX 9746, PORTLAND, ME 04104-5040
(207) 799-3888
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN59802
ME
363LF0000X
Family Nurse Practitioner
Primary
CNP131041
ME
Other
Enumeration date
12/06/2013
Last updated
10/22/2021
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