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General NPI Number Information
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NPI Number | 1639979453
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Entity Type | Individual
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Provider Name | JILL ALISON CARBAUGH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 354 MILL ST
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6138
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Country | US
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Telephone | 301-797-0210
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Fax |
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Provider Business Mailing Address
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Address Line | 6140 SCARLET OAK DR
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City | MERCERSBURG
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State | PA
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Zip | 17236-8570
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Country | US
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Telephone | 240-313-5826
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R162573
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License Number State | MD
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