Provider Demographics
NPI:1033183272
Name:LINTON, JILL
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:LINTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 MEMORIAL DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-7056
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:195 MEMORIAL DR
Practice Address - Street 2:SUITE 6
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-7056
Practice Address - Country:US
Practice Address - Phone:814-623-1104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN502845L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP49811Medicare UPIN