MEDICARE: MRS. JILL ELLEN LAUGHLIN C-PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP116192	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.27598	SC
3	363LP0200X	Pediatric Nurse Practitioner	544266	TX

General Provider Information

NPI Number	:	1891987400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JILL ELLEN LAUGHLIN C-PMHNP

Provider Business Mailing Address
First Line	:	25 CLARK SUMMIT DR # F201
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-4205
Country	:	US
Telephone Number	:	843-757-4737
Fax Number	:	843-757-4585

Provider Business Practice Location Address
First Line	:	25 CLARK SUMMIT DR # F201
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-4205
Country	:	US
Telephone Number	:	843-757-4737
Fax Number	:	843-757-4585

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	02/12/2026

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