Healthcare Provider Details

I. General information

NPI: 1033183272
Provider Name (Legal Business Name): JILL LINTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 05/21/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 MEMORIAL DR SUITE 6
EVERETT PA
15537-7056
US

IV. Provider business mailing address

195 MEMORIAL DR SUITE 6
EVERETT PA
15537-7056
US

V. Phone/Fax

Practice location:
  • Phone: 814-623-1104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN502845L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: