Healthcare Provider Details

I. General information

NPI: 1447304126
Provider Name (Legal Business Name): JILL BOYLE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JILL A NESTLE

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 N 7TH ST
STROUDSBURG PA
18360-2110
US

IV. Provider business mailing address

190 KINSALE LANE PO BOX 389
DINGMANS FERRY PA
18328
US

V. Phone/Fax

Practice location:
  • Phone: 570-424-8306
  • Fax: 570-476-4580
Mailing address:
  • Phone: 570-828-2028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNN06230300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: